Zoloft (Sertraline) Medication Information

Panic Disorder Treatment: Zoloft/Sertraline

Zoloft (sertraline HCl) is an SSRI antidepressant manufactured by Pfizer. It was first marketed as a treatment for depression in 1992. Zoloft is now approved by the FDA for the treatment of:

Dosage Information

Zoloft is manufactured in scored tablets of 25mg, 50mg, and 100 mg. It is also available in a liquid oral concentrate. Your doctor may begin therapy with a low dose that is gradually increased. Zoloft is usually taken once each day and may be taken with or without food.

Side Effects

The most common side effects associated with Zoloft include:

  • Dry mouth
  • Dizziness
  • Nausea
  • Diarrhea
  • Decreased sex drive
  • Ejaculatory and orgasmic delay or impairment
  • Increased sweating

Some people find that many of these side effects improve after being on the medication for a while. But, if they remain bothersome, you should consult your doctor or other healthcare professional.

If you experience any of these less common side effects, you should call your doctor right away:

  • Agitation or irritability
  • Restlessness
  • Impulsiveness
  • Hyperactivity
  • Tremors
  • Confusion

You should get emergency medical attention if you experience any of the following rare, but serious, side effects:

  • Allergic reaction (including hives, skin rash, difficulty breathing, difficulty swallowing, or swelling of your face, lips, or tongue)
  • Seizures
  • Suicidal thoughts

How Long Does Zoloft Take to Work?

Some people experience some improvement in symptoms within one or two weeks of starting Zoloft. However, the full therapeutic effect is generally achieved in about eight weeks.

Is Zoloft Addictive?

Based on clinical studies, Zoloft is not believed to be addictive or habit-forming.

What if I Miss a Dose?

Take the missed dose as soon as you remember, unless it’s nearly time to take your next dose. Do not take extra Zoloft to make up the missed dose.

Precautions and Contraindications

  • Pregnancy. There is evidence that taking Zoloft during the third trimester of pregnancy may increase your baby’s risk of developing persistent pulmonary hypertension, which is a serious, and potentially fatal, lung disorder. If you are nursing or are pregnant, it is best to discuss the risks and benefits of Zoloft therapy with your doctor.
  • NSAIDs or aspirin. Use of Zoloft with NSAIDs or aspirin may be associated with an increased risk of bleeding.
  • Liver or kidney disease. Before taking Zoloft, tell your doctor if you have impaired liver or kidney function. Depending on your condition, your doctor may need to adjust your dose and perform certain tests while on Zoloft therapy.
  • Alcohol. Drinking alcohol with Zoloft is not recommended.

Serotonin Syndrome

Any SSRI antidepressant has a risk of producing a potentially life-threatening condition called serotonin syndrome.

This rare condition is usually the result of an interaction of two or more drugs that affect brain serotonin levels.

Even some over-the-counter supplements, such as St. John’s Wort, may increase the risk of serotonin syndrome if mixed with SSRIs.

Particularly troublesome is mixing SSRIs with a class of antidepressants called monoamine oxidase inhibitors (MAOIs). SSRI's can be started two weeks after stopping an MAOI. MAOIs can be started two weeks after stopping an SSRI, with the exception of Prozac (fluoxetine) given its long half-life. MAOI's should not be started until five weeks after stopping Prozac due to the increased risk of serotonin syndrome.

SSRI Discontinuation Syndrome

Before discontinuing Zoloft, talk to your doctor. Some people have reported withdrawal-like symptoms when decreasing or stopping SSRI therapy. It is believed that these symptoms are the result of the brain trying to stabilize serotonin levels after an abrupt change.

Symptoms that may occur during discontinuation of any SSRI therapy include:

  • Nausea
  • Headache
  • Muscle Aches
  • Dizziness
  • Electric shock-like sensations in the neck and head

While all of these symptoms are not believed to be dangerous, they can be quite disconcerting. When discontinuing an SSRI, your doctor may give you a gradual reduction schedule to avoid these sertraline withdrawal symptoms.

FDA Black Box Warning

The association of increased suicidal thoughts and behaviors, especially among children, adolescents, and young adults with SSRI treatment, has been a center of attention and controversy in recent years. In response to the concerns suggested in case studies and some research, the U.S. Food and Drug Administration (FDA) issued a statement in 2007.

The FDA proposed that makers of all antidepressant medications indicate a warning on their products about a possible increased risk of suicidal thinking and behavior in children, adolescents, and young adults, up to the age of 24, particularly during initial treatment.

By Sheryl Ankrom, MS, LCPC
Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders.