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Sertraline 101: What It Is, How It Works & Side Effects

Sertraline 101: What It Is, How It Works & Side Effects

Sertraline is an antidepressant that’s part of the selective serotonin reuptake inhibitor (SSRI) class of medications.

Like other SSRIs, sertraline is most commonly used to treat depression, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and panic attacks. It’s also used as a treatment for premature ejaculation (PE).

In the United States, sertraline is best known under the brand name Zoloft. With tens of millions of prescriptions written for it every year in the U.S. alone, it’s one of the most widely used SSRIs on the market.

Below, we’ve explained how sertraline works as a medication, what conditions it’s used for and how you can use it effectively. We’ve also listed the most common sertraline side effects and interactions to be aware of if you use it for depression, panic attacks or any other condition.

How Does Sertraline Work?

Sertraline is a selective serotonin reuptake inhibitor, or SSRI. Other medications in this class include fluoxetine (Prozac) and paroxetine (Paxil).

Approved by the FDA in 1991 for use treating major depressive disorder (MDD), sertraline works by increasing the level of serotonin, a major neurotransmitter, in your brain. By increasing serotonin levels, sertraline can help to prevent panic attacks, improve your general mood and stop some obsessive compulsive behaviors.

People with social anxiety disorder also notice benefits from using sertraline, as it can help with some symptoms of anxiety.

Sertraline is also associated with increases in ejaculation latency (longer ejaculation time) in men with premature ejaculation and is prescribed off-label to help with that. We’ve covered this in more detail in our guide to premature ejaculation and sertraline.

Available in tablet form, sertraline is designed for use everyday. It’s a prescription medicine, meaning you’ll need to talk to your doctor and receive a prescription before you can use it to treat depression, anxiety or any other conditions.

For most people, sertraline take a few weeks to start working effectively. However, many people who use sertraline notice benefits shortly after starting the medication. When used off-label to treat premature ejaculation, studies suggest it can be used on an as-needed basis.

What is Sertraline Used For?

Sertraline is a versatile medication that’s used to treat several conditions. It’s most commonly used to treat:

  • Depression. Sertraline is an antidepressant and is often prescribed as a treatment for major depressive disorder (MDD). Studies show that significantly more people affected by depression recover when using sertraline compared to a non-therapeutic placebo.

  • Obsessive-Compulsive Disorder (OCD). Sertraline is an effective drug for treating OCD. In a 1992 study, researchers found that people with OCD experienced measurable improvements after eight weeks of treatment using sertraline.

  • Posttraumatic Stress Disorder (PTSD). Sertraline is frequently recommended as a first-line pharmacological treatment for PTSD. A 2016 scientific review found that 65.6% of patients with PTSD experienced improvements after using sertraline.
  • Body Dysmorphic Disorder (BDD). Sertraline is one of several SSRIs used to treat body dysmorphic disorder, a common disorder that causes people to obsessively think negatively about their real or imagined physical flaws.
  • Social Anxiety Disorder (SAD). Studies show that sertraline is an effective treatment for social anxiety disorder. In a 2006 study, researchers found that sertraline performed significantly better than a non-therapeutic placebo in reducing social anxiety symptoms.

How Do You Take Sertraline?

Sertraline usually comes in tablet form. There are three different sertraline dosage forms—a 25mg tablet, a 50mg tablet and a 100mg tablet. Sertraline is also available as an oral solution, typically with a 20mg per mL concentration.

There’s no one-size-fits-all sertraline dosage. Most of the time, doctors prescribe a starting dosage of 50mg per day to treat depression, panic disorder, social anxiety disorder, PTSD and several other conditions. This sertraline dosage can be adjusted based on the patient’s response.

The maximum dose for sertraline is 200mg per day. This dose is typically used for patients who don’t respond to lower doses and is the result of gradually increasing their sertraline dosage over the course of several weeks or months.

For conditions such as premature ejaculation, a normal dose of sertraline is 25 to 100mg daily, depending on the patient’s symptoms and response to the medication.

When prescribed to children, the standard dose of sertraline can range from 25mg to 50mg per day, or 50 to 200mg for children from 6 to 17 years of age.

Sertraline is designed for use once per day. For best results, you’ll need to take sertraline at the same time every day. It’s okay to take sertraline on an empty stomach or after eating a meal, as food does not appear to have a significant impact on your body’s ability to absorb the drug.

If you’re prescribed sertraline and forget to take a dose, wait until your next dose, then take it as usual. You should not take two doses of sertraline at a time, even if you forgot the previous dose of the medication.

What are Sertraline Side Effects?

Overall, sertraline is a safe and effective medication. However, like most SSRIs, sertraline side effects do occur. Most sertraline side effects are minor and occur during the first few weeks of using sertraline. Common sertraline side effects include:

  • Fatigue and tiredness. Tiredness is a common side effects of sertraline and other SSRIs. It’s most common during the first few weeks of treatment and usually fades away on its own as your body becomes more accustomed to the medication.

    One way to deal with tiredness from sertraline is to take the medication at night, which will often lighten its effects on your energy levels during the daytime.

  • Difficulty sleeping. Some people experience insomnia after using sertraline. This can contribute to daytime tiredness, making it hard to maintain your normal routine. Using sertraline in the morning can often make falling and staying asleep easier.

  • Reduced appetite. It’s common to experience a reduced appetite after you start taking sertraline. Like other side effects, this tends to pass after a few weeks. To avoid losing weight, try to maintain your normal eating habits and caloric intake.
  • Headaches. Sertraline can cause you to experience mild headaches, particularly in the first few weeks of using the medication.

    Headaches from sertraline typically disappear after several weeks or months, as your body becomes accustomed to the medication. The best way to treat headaches from sertraline is to stay hydrated, use over-the-counter pain medication and avoid alcohol.
  • Dizziness. Dizziness is one of the most common side effects of sertraline. Like other side effects, it’s most common during the first few weeks of treatment and will usually stop as the medication reaches a steady state in your body.
  • Diarrhea. Like other common side effects of sertraline, diarrhea can occur during the first few weeks of treatment. If you have diarrhea after using sertraline, make sure you drink plenty of fluids to avoid becoming dehydrated.
  • Dry mouth. During the first few weeks of taking sertraline, you might experience dry mouth. This can be treated by chewing on sugar-free gum, drinking water regularly, avoiding cigarettes and making an effort to breathe only through your nose.
  • Sexual side effects. Sertraline is one of several antidepressants that can cause sexual side effects, such as difficulty getting an erection and a reduced libido. Some men find it more difficult to orgasm after starting sertraline.

  • Weight gain. Like other SSRIs, sertraline is linked to weight gain. About 25% of people who use SSRIs and other antidepressants experience some amount of weight gain as a result of appetite, diet and activity level changes.

    Just like avoiding weight loss, avoiding weight gain from sertraline can be managed by maintaining your normal eating habits, activity level and caloric intake.

Over time, these side effects should fade as sertraline reaches a steady state in your body. If you experience persistent side effects from sertraline that do not get better over the course of one month, you should contact your doctor.

Sertraline is also linked to several serious side effects. These side effects occur rarely and only affect a tiny percentage of people who use sertraline, however, they are worth mentioning. Rare side effects of sertraline include:

  • Fainting and extreme dizziness. A small percentage of people who use sertraline may experience extreme dizziness, lightheadedness and fainting.

  • Priapism (painful, long-lasting erection). Sertraline is one of several drugs linked to priapism, a type of persistent, painful erection that lasts for longer than four hours and can cause permanent damage to your body.

  • Chest pain. Although rare, sertraline is linked to some cases of chest pain and difficulty breathing.
  • Persistent bleeding. Sertraline and other SSRIs can act as a blood thinner, meaning it may affect your body’s ability to form blood clots. This can lead to persistent bleeding if you cut yourself or experience a nosebleed.
  • Suicidal thoughts. Although very rare, clinical trials show that sertraline may contribute to an increase in suicidal thoughts and suicide-related events.

If you experience any of the five side effects listed above, you should seek medical assistance immediately. These are rare, potentially serious side effects that need to be treated by a medical professional.

Overall, sertraline is a safe and effective medication. It’s been used for decades to treat a range of conditions with few cases of significant side effects. It’s also safe to use for the long term, with few patients experiencing negative effects after using sertraline for several months or years.

Can Sertraline Interact With Other Medications?

Like other SSRIs, sertraline can interact with other medications. The most common interactions with sertraline involve medications that treat depression, such as other antidepressants, as well as medications that can affect your heart rate and cardiovascular function.

According to Drugs.com, sertraline interacts with a total of 1,188 other medications. This list of interactions includes 271 major drugs that have the potential to negatively affect your health and wellbeing.

Sertraline can also interact with some non-pharmaceutical herbal supplements. Common herbal depression treatments like St. John's Wort are known to interact with sertraline and other SSRI medications, increasing your risk of some side effects.

If you use any prescription medications or herbal supplements, make sure you tell your doctor before considering sertraline.

Is it Safe to Drink Alcohol While Using Sertraline?

The FDA recommends avoiding alcohol completely while you use sertraline. Alcohol’s activity on your brain’s neurotransmitters can reduce the effectiveness of sertraline. Drinking alcohol is also linked to higher rates of side effects from SSRIs such as sertraline.

If you experience tiredness or fatigue after using sertraline, alcohol has the potential to make these side effects worse. If you use sertraline to treat depression, there’s also a significant risk of alcohol worsening your depression symptoms.

In short, while you use sertraline or any other SSRI, it’s best to completely avoid drinking any beverages that contain alcohol. Our guide to sertraline and alcohol goes into greater detail on the dangers of drinking while using sertraline and other SSRIs.

Learn More About Sertraline

Used regularly by tens of millions of people in the United States alone, sertraline is one of the most common SSRIs on the market. It’s safe, highly effective and versatile, treating a range of common health conditions.

Our sertraline FAQ answers the most common questions about sertraline in greater detail, with links to detailed studies and more.