Zoloft for Anxiety

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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.

how to take zoloft
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 Zoloft
  • Are being treated with medication for alcohol abuse
  • Are breastfeeding
  • Are pregnant (especially in the third trimester) or planning to become pregnant
  • Have bipolar disorder or a family history of bipolar disorder
  • Have 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.

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:

  • Nausea
  • Drowsiness
  • Sweating
  • Dizziness
  • Dry mouth
  • Diarrhea
  • Decreased appetite
  • Sexual dysfunction
  • Insomnia

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.

  • 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.
  1. U.S. National Library of Medicine, ZOLOFT— sertraline hydrochloride tablet.

  2. Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017;189(21):E747. doi:10.1503/cmaj.160991

  3. Simon LV. Serotonin syndrome. National Center for Biotechnology Information (NCBI), U.S. National Library of Medicine, NIH.

  4. Foong AL, Grindrod KA, Patel T, Kellar J. Demystifying serotonin syndromeCan Fam Physician. 2018;64(10):720-727.

  5. 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

  6. 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 trialThe Lancet Psychiatry. 2019;6(11):903-914. doi:10.1016/S2215-0366(19)30366-9

Additional Reading

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."