Sertraline (Zoloft) is an antidepressant drug. People who take Zoloft may have mild to severe side effects including nausea, heart palpitations, dizziness, and sleep problems.
Zoloft belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). Doctors prefer to prescribe SSRIs over other classes of antidepressants because their side effects are often less troublesome.
However, side effects are common. Mild symptoms include nausea, sleep problems, and sexual problems. In severe cases, people can experience suicidal thoughts.
Speak to a healthcare professional about any concerning side effects. The doctor can help a person wean off the drug, change medications, or develop ways to manage side effects.
In this article, we describe the different side effects and warnings associated with Zoloft.
Zoloft can help treat a range of mental health conditions.
The Food and Drug Administration (FDA) have approved Zoloft as a treatment for:
- major depressive disorder
- obsessive-compulsive disorder, better known as OCD
- panic disorder
- post-traumatic stress disorder, better known as PTSD
- social anxiety disorder
- premenstrual dysphoric disorder
SSRIs, such as Zoloft, increase the amount of serotonin in the brain. Doctors agree that serotonin is one of the chemicals in the brain involved in many psychiatric disorders.
People may experience side effects when taking Zoloft. Some affect the heart or the nervous or digestive systems, while others influence mental or sexual health.
The following table lists the most common side effects of Zoloft.
| Heart | palpitations (4%) |
| Vision | visual disturbances (4%) |
| Stomach and digestive system | nausea (26%) diarrhea (20%) dry mouth (14%) acid reflux (8%) constipation (6%) vomiting (4%) |
| Appetite | decreased appetite (7%) |
| Nervous system | dizziness (12%) drowsiness (11%) shaking (9%) |
| Psychiatric conditions | sleeplessness (20%) agitation (8%) decreased sex drive (6%) |
| Sexual health | ejaculation failure (8%) erectile dysfunction (4%) ejaculation disorder (3%) male sexual dysfunction (2%) |
| Other | fatigue (12%) excessive sweating (7%) |
All antidepressants, including Zoloft, may increase the risk of suicidal thoughts or actions in people under the age of 24, especially in the first few weeks of treatment or after a change in dosage.
Doctors must check in with children and young adults taking Zoloft about any suicidal thoughts or behaviors, especially when the person starts the drug or takes a new dosage.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
If any side effects are getting worse, the doctor should consider ending Zoloft as a treatment.
Anyone with a severe allergy to sertraline should not take Zoloft.
Some doctors prescribe Zoloft as an oral solution, which contains alcohol as a nonmedicinal ingredient.
People who are taking this solution should avoid disulfiram because it interacts with alcohol. Symptoms of an interaction
- excessive sweating
- a rapid heartbeat
- facial flushing
- nausea
- dizziness
- a drop in blood pressure
- heart palpitations
People may need to stop taking Zoloft if they are experiencing severe side effects, but doctors do not recommend stopping abruptly.
People who abruptly stop taking Zoloft, or any SSRI, can experience severe side effects. These, collectively, are called discontinuation syndrome.
The side effects happen because the body has not had time to adjust to no longer having the drug.
To avoid discontinuation syndrome, the doctor should gradually decrease a person’s dosage.
The symptoms of discontinuation syndrome include:
- irritability
- agitation
- dizziness
- anxiety
- mood swings
- an elevated mood
- confusion
- headache
- a decrease in energy levels
- nausea
- sweating
- sleeplessness
- electric shock sensations
- shaking
- ringing in the ears
- seizures
Certain drugs interact with Zoloft, so it is important to tell the doctor about any other medications.
Monoamine oxidase inhibitors
People taking monoamine oxidase inhibitors (MAOIs) should not take Zoloft.
MAOIs increase the level of serotonin in the brain. Zoloft does this as well, and combining it with an MAOI can result in serotonin syndrome.
Some drug combinations are riskier than others, and some people are more susceptible to developing serotonin syndrome.
People must stop taking MAOIs 14 days before starting Zoloft.
Pimozide
People taking pimozide (Orap) should not take Zoloft.
Pimozide is an antipsychotic medication that people with Tourette’s syndrome use to control tics.
Doctors report that combining pimozide and Zoloft can further increase the levels of pimozide in the bloodstream, which can affect the heart. People combining these drugs have an increased risk of a heart problem called QTc prolongation.
QTc prolongation is a condition that affects the heart rhythm. Doctors detect it using an electrocardiogram, or ECG.
This prolongation can
Blood thinners
Zoloft can increase the risk of bleeding.
Use caution when taking Zoloft and any of the following:
- aspirin
- nonsteroidal anti-inflammatory drugs, commonly called NSAIDs
- warfarin or other blood thinning medication
Taking Zoloft alongside these drugs can cause stomach or intestinal bleeding.
Zoloft is safe early in a pregnancy, but in the third trimester, doctors need to weigh the benefits with the potential risks to the fetus.
A baby exposed to Zoloft late in the third trimester has a risk of developing complications that may require a hospital stay. Some babies experience discontinuation syndrome, and doctors need to monitor babies who were exposed to Zoloft late in pregnancy.
Women who are breastfeeding can take Zoloft because the body releases only low amounts into breastmilk.
The liver digests Zoloft. If the liver is not functioning well, more Zoloft remains in the person’s bloodstream.
People with liver failure can take Zoloft, but doctors may need to adjust the dosage. If someone has mild liver failure, the doctor will prescribe half the usual dosage, for example.
Doctors will not prescribe Zoloft to anyone with moderate or severe liver failure.
If side effects are severe or do not go away, it is important to let the doctor know.
Depending on the severity of the side effects, doctors may lower the dosage or recommend a different antidepressant.
Stomach and digestive side effects usually depend on the dosage that a person is taking and often go away after a few weeks. If the drug is causing an upset stomach, take it with food.
This may also prevent abdominal bleeding in people who are at risk.
Sleep disturbances and agitation also tend to decrease over time. People who experience sleeplessness with Zoloft should try taking the drug in the morning. Others who feel fatigued when taking Zoloft may find that it helps to take the drug at night.
Sexual dysfunction in males is a side effect of this and other antidepressants, except bupropion (Wellbutrin) and buspirone (Buspar). Anyone experiencing erectile dysfunction because of Zoloft may choose to stop taking the drug.
Doctors can prescribe phosphodiesterase-5 inhibitors, such as sildenafil (Viagra) or tadalafil (Cialis), to males who take antidepressants and experience sexual dysfunction.
People take Zoloft to treat psychiatric disorders, including depression.
Mild side effects, such as nausea and sleep problems, are relatively common. These side effects often go away over time.
If side effects are getting in the way of daily life or if they are severe, speak to a doctor about changing dosages or medications.
Some people cannot take Zoloft, and some drugs interact with it. It is important to discuss the risks with a doctor.
Abruptly stopping treatment with Zoloft or another antidepressant can lead to discontinuation syndrome. To prevent this, doctors recommend reducing the dosage gradually.