Social Anxiety Disorder Treatment and Therapy Zoloft for Anxiety By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on April 08, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Amy Morin, LCSW Medically reviewed by Amy Morin, LCSW Facebook LinkedIn Twitter Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a psychotherapist, the author of the bestselling book "13 Things Mentally Strong People Don't Do," and the host of The Verywell Mind Podcast. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Zoloft for Anxiety Precautions Dosage Side Effects Warnings and Interactions Zoloft (sertraline hydrochloride) is a prescription medication typically used to treat depression. However, the FDA has also approved it for the treatment of social anxiety disorder, a mental health condition marked by an irrational fear of being watched or judged, or of embarrassing or humiliating oneself. Zoloft for Anxiety Zoloft is a selective serotonin reuptake inhibitor (SSRI), which works to slow the reabsorption of the neurotransmitter serotonin, a chemical that helps regulate mood and control anxiety. Clinicians also use it to treat other mental health conditions, including major depressive, obsessive-compulsive, premenstrual dysphoric, panic, and post-traumatic stress disorders. Illustration by Alexandra Gordon, Verywell Precautions When Taking Zoloft for Anxiety Use Zoloft with caution if you: Are allergic to sertraline, the active ingredient in ZoloftAre being treated with medication for alcohol abuseAre breastfeedingAre pregnant (especially in the third trimester) or planning to become pregnantHave bipolar disorder or a family history of bipolar disorderHave impaired liver or kidney function, heart disease, diabetes, or a history of seizures The FDA has not approved Zoloft for the treatment of social anxiety disorder in people under 18 years of age. Evidence suggests an increased risk of suicidal thoughts and behaviors in children taking Zoloft. If you or your child are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Precautions to Take Before Using Zoloft Zoloft Dosage for Anxiety Zoloft is available in 25, 50, and 100 mg tablets and a 20 mg/ml oral solution. Check your prescription and consult your doctor to make sure you're taking the correct dose. For people with social anxiety disorder, a typical dosage of Zoloft starts at 25 mg, with an increase to 50 mg after one week. Weekly increases up to a maximum dose of 200 mg are permitted for patients who do not respond to lower doses. Modifications Certain populations may require an adjusted dosage and/or close monitoring by their healthcare provider. Children 6 to 17 years old may require closer monitoring and a subsequent dosage change if they experience significant weight loss and/or suicidal ideation during the first few months of taking Zoloft.People who are pregnant or nursing must discuss the risk and benefits of taking Zoloft, because it can pose a risk to the fetus during the third trimester and to the newborn while breastfeeding.Older patients begin with lower dosages so prescribers can monitor them for adverse reactions before increasing dosages if needed. How to Take and Store Generally, expect to take Zoloft once daily, with or without food, within the following guidelines. Swallow the tablets whole, not chewed or crushed. If you're taking the liquid form, combine the prescribed amount of medication with one-half cup of liquid (water, ginger ale, lemon-lime soda, lemonade, or orange juice). Prepare each dose immediately before you take it, not in advance. If you forget to take a daily dose, take it as soon as you remember. However, if it is close to the time of your next dose, skip the missed dose and take it at your regular time. Never take two doses of Zoloft at the same time. When traveling, store Zoloft in your carry-on baggage in case your luggage gets lost. It's important to continue taking Zoloft as long as your doctor instructs, even if you begin to feel better. If you abruptly stop taking Zoloft, you may experience sertraline withdrawal symptoms such as nausea, tremors, lightheadedness, muscle pains, weakness, insomnia, and anxiety. Zoloft Overdose The risk of a fatal overdose of Zoloft is low. Nevertheless, if you've taken too much Zoloft, get help right away before the drug has a chance to cause unpleasant or dangerous symptoms. Symptoms of an overdose include dizziness, drowsiness, nausea, vomiting, increased or slow heart rate, and coma. Zoloft Side Effects Side effects of Zoloft can range from mild to more serious. Common Side Effects The most common side effects of Zoloft include: NauseaDrowsinessSweatingDizzinessDry mouthDiarrheaDecreased appetiteSexual dysfunctionInsomnia Severe Side Effects When first starting Zoloft or changing your dosage, report any of the following side effects to your doctor immediately: Allergic reaction symptoms such as hives, rash, difficulty swallowing or breathing, severe dizziness, and swelling of the face, mouth, throat, or tongue Agitation Changes in urine or stools (dark or increased urine, black stools) Nervousness Persistent vomiting or nausea Seizures Severe abdominal pain Suicidal thoughts and behaviors Tremors Yellowing of the eyes or skin Symptoms of serotonin syndrome, including agitation, confusion, sweating, hallucinations, abnormal reflexes, muscle spasms, and rapid heartbeat When to Go to the ER If your doctor is unavailable and you're experiencing severe symptoms, head to the emergency room immediately. Tell the medical personnel about the medication, the dosage you're taking, and when your symptoms began. Warnings and Interactions Take Zoloft as directed, unless your healthcare provider gives other guidance. To ensure Zoloft is safe for you, disclose to your doctor your mental health and family history; all current or past prescription and over-the-counter medications; and any other substances that you are taking or plan to take. Warnings and interactions when taking Zoloft include the following: Zoloft is not approved for use by children under age 6. Don't take it in combination with, or within weeks of taking, monoamine oxidase inhibitors (MAOIs), pimozide, and disulfiram (in the case of liquid Zoloft). Don't take Zoloft with such supplements as St. John's Wort, 5-HTP, or SAMe due to the risk of serotonin syndrome. Don't take it with aspirin, anticoagulants, and nonsteroidal anti-inflammatory drugs, which may increase the risk of bleeding. Consumption of illegal drugs and alcohol is not advised while taking Zoloft. Avoid grapefruit and grapefruit juice; they can interfere with how your body metabolizes the medication. Zoloft may make you feel drowsy and less alert. Don't drive, operate dangerous machinery, or participate in hazardous activities unless you are sure that Zoloft is not affecting you in this way and you've worked out the best time of day to take Zoloft for your anxiety. Be mindful of any unusual changes in behavior or mood six to eight weeks after beginning Zoloft. If symptoms worsen, contact your doctor immediately. Black-Box Warning The black-box warning for Zoloft indicates that it may cause or increase thoughts of suicide in children and young adults (under 25), especially in the first few weeks after starting the drug or changing the dosage. A Word From Verywell This article does not indicate every possible outcome of taking Zoloft. Always follow your doctor's guidelines, and consult your healthcare provider or pharmacist right away if you have any questions or concerns. Frequently Asked Questions Does Zoloft help with anxiety? Although clinicians most often prescribe Zoloft to treat depression, the FDA has approved it to treat social anxiety disorder, too. Learn More: What to Know About Zoloft (Sertraline) Is 25mg of Zoloft enough for anxiety? Pfizer, the manufacturer of Zoloft, lists the starting dosage for anxiety at, 25 mg per day. Your doctor may increase your dosage, typically by 25 mg per week, up to a maximum of 200 mg per day. The optimum dosage for anxiety depends on the individual; your doctor will weigh the benefits of increasing your dosage against the side effects you experience. How long does Zoloft take to work for anxiety? Research indicates that many people find some relief from anxiety symptoms within the first six weeks of starting Zoloft. When should you increase your Zoloft dosage for anxiety? Your doctor is likely to increase your Zoloft dosage if your anxiety symptoms fail to improve within the first few weeks of beginning your treatment with the drug. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S. National Library of Medicine, ZOLOFT— sertraline hydrochloride tablet. Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017;189(21):E747. doi:10.1503/cmaj.160991 Simon LV. Serotonin syndrome. National Center for Biotechnology Information (NCBI), U.S. National Library of Medicine, NIH. Foong AL, Grindrod KA, Patel T, Kellar J. Demystifying serotonin syndrome. Can Fam Physician. 2018;64(10):720-727. Lee AJ, Chan WK, Harralson AF, Buffum J, Bui B-CC. The effects of grapefruit juice on sertraline metabolism: An in vitro and in vivo study. Clinical Therapeutics. 1999;21(11):1890-1899. doi: 10.1016/S0149-2918(00)86737-5 Lewis G, Duffy L, Ades A, et al. The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (Panda): A pragmatic, double-blind, placebo-controlled randomised trial. The Lancet Psychiatry. 2019;6(11):903-914. doi:10.1016/S2215-0366(19)30366-9 Additional Reading Pfizer. Zoloft: tablets and oral concentrate. By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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