Side Effects of Zoloft (Sertraline)

Zoloft is among the most prescribed psychiatric drugs in the U.S. Common side effects from Zoloft can include fatigue, nausea, sleepiness, weight gain, and sexual problems

Zoloft (sertraline) is an antidepressant medication used to treat depression and anxiety. It belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which work by preventing the reabsorption of serotonin (the "feel good" neurotransmitter) so that more is available in the system.

Knowing what to expect and finding ways to cope can help you better manage these side effects. This article discusses some of the most common side effects from Zoloft, as well as some that are less expected and what you can do to cope.

Common Side Effects From Zoloft

As with all medications, Zoloft may cause certain unwanted side effects. The most commonly experienced in those taking Zoloft include:

• Decreased appetite
• Diarrhea
• Fatigue
• Feeling emotionally numb
• Increased sweating
• Indigestion
• Insomnia
• Nausea
• Sexual problems, including loss of libido and inability to ejaculate or orgasm
• Sleepiness
• Tremors
• Weight gain

Gastrointestinal problems can occur quite frequently in people taking Zoloft. Others are far less common but may be more distressing.

Nausea

Nausea is the most common side effect from Zoloft, affecting around one in every four people who take sertraline. While common, this side effect typically abates over time. 

You will most likely feel nauseous when you first begin taking your medication or your doctor increases your dose. You may find it helpful to take your medication with food and try nausea relief remedies such as drinking ginger tea. 

Trouble Sleeping

Around one in five people will experience insomnia as a side effect from Zoloft. However, some strategies can help people manage this side effect, such as taking the medication in the morning. 

If you do find that you have difficulty falling or staying asleep while taking Zoloft, practicing good sleep habits can also be helpful. Go to sleep at the same time each night and limit your caffeine intake during the day, especially in the afternoon and evenings.

Sexual Side Effects From Zoloft

While the loss of libido and orgasmic difficulties can affect both men and women, men are especially impacted by physical symptoms of erectile dysfunction.

These sexual issues occur in a small percentage of men taking Zoloft. People can sometimes minimize these symptoms by taking Zoloft immediately after sex or adjusting treatment with their doctor's advice.

Weight Gain

Another potential side effect of Zoloft is weight gain. A long-term study published in the British Medical Journal (BMJ) in 2018 found that for up to six years after starting treatment, people taking antidepressants such as Zoloft were 21% more likely to experience at least a 5% weight gain than those not taking the drugs. Participants were also 29% more likely to move up a weight category—from normal to overweight or from overweight to obese—than those not on antidepressants.

While experts are still trying to figure out the link, some theories exist. For one, SSRIs can trigger changes in your metabolism, increasing appetite and causing the body to burn off calories less efficiently. Also, many people lose their appetite and lose weight when they’re depressed, so it may just be a result of them feeling better when they’re on the drug.

Less Common Side Effects From Zoloft

While far less common, there are some serious side effects associated with Zoloft use. In some cases, Zoloft may trigger or exacerbate psychiatric symptoms.

Call your doctor if you experience any new or worsening psychiatric symptoms, including:

• Agitation
• Anxiety
• Hallucinations
• Impulsiveness
• Memory loss
• Symptoms associated with psychosis, major depression, or mania

You should seek immediate medical assistance if you experience any of the following:

• Black or bloody stools
• Chest pain
• Fainting
• Fast or irregular heartbeat
• Fever over 100^o F
• Seizure
• Severe or persistent headache
• Skin reactions
• Suicidal thoughts

Side Effects in Children and Adolescents

When prescribed in children or adolescents, Zoloft can cause a slightly different range of side effects, some of which are less common in adults.

Advise your pediatrician if your child experiences any of the following:

• Abnormal or agitated muscle movements
• Frequent urination
• Heavy menstrual period
• Nosebleeds
• Slowed growth
• Urinary incontinence
• Weight changes

Serotonin Syndrome

Because Zoloft affects serotonin levels in the brain, it also has the potential to cause serotonin syndrome. Serotonin syndrome is a condition in which serotonin levels become too high. Symptoms of the condition include:

• Agitation
• Confusion
• Diarrhea
• Irregular heartbeat
• Loss of consciousness
• Muscle twitching
• Seizures
• Shivering
• Sweating

This condition is more likely to occur if you take Zoloft with another medication that affects serotonin levels, such as a different antidepressant or a supplement such as St. John's wort. Some other psychiatric medications, painkillers, antibiotics, supplements, and drugs such as amphetamines, cocaine, and LSD can also increase serotonin.

Coping With Side Effects From Zoloft

The type and severity of Zoloft side effects will vary from person to person. Most symptoms tend to be minimal and generally improve over time. Common side effects typically last one to two weeks until you get used to your medication.

If you find you are unable to cope with the side effects, call your doctor immediately. There may be strategies your doctor can offer (including dose adjustment or adjunctive therapies) to help you better adjust to the prescribed treatment.

Not only might you undermine the goals of treatment, but you may also experience a condition known as antidepressant discontinuation syndrome (ADS) which can manifest with symptoms of sertraline withdrawal (including muscle aches, nausea, dizziness, insomnia, and abnormal sensations). ADS can occur as early as six weeks after starting therapy.

A Word From Verywell

Side effects from Zoloft tend to be manageable and often go away on their own as your body adjusts to your medication. It typically takes several weeks for an antidepressant to begin working, so it is important to give your medication time to work. Talk to your doctor about your symptoms if you are concerned about side effects. They can suggest ways to cope or make medication changes if needed.