Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary:
- Zoloft® (sertraline) is an SSRI used to treat major depressive disorder and several different anxiety disorders by increasing serotonin levels, which can improve your mood and emotional well-being.
- Zoloft® can have mild and serious side effects, including nausea, diarrhea, and decreased libido, with more severe risks including serotonin syndrome and heartbeat irregularities.
- Effectiveness varies by individual. Some studies show Zoloft® outperforming other antidepressants in specific cases, but responses to the drug differ from person to person.
- Certain populations face unique risks with Zoloft®. These may include increased suicidal thoughts in young people, sodium imbalances in older adults, and potential risks for pregnant women.
- Consult a healthcare provider before and during Zoloft® use to monitor your side effects and adjust your dosage if needed.
Zoloft® helps many people with depression & anxiety—but it isn’t for everyone
Zoloft® is the branded version of sertraline, an SSRI commonly used to treat major depressive disorder and several types of anxiety disorders. But, if you’re planning to talk to your healthcare provider about taking Zoloft®, you should also be aware of the possible side effects of this medication.
Like all medications, Zoloft® can have side effects. Some of these are mild and more common, whereas others can be more rare and severe. Below, you’ll find our guide to understanding the side effects you might experience when taking Zoloft®, as well as our advice on how to make them less likely and what to do if they occur.
How Zoloft® works
Zoloft® belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). These drugs are commonly used as first-line treatments for depression and other psychiatric disorders due to their relative safety and effectiveness, and are well-tolerated by most people who take them.
SSRIs work by stopping a naturally-occurring brain chemical called serotonin from being reabsorbed too quickly after your body produces it. This raises the total level of serotonin in your system. Since serotonin affects your mood, personality, and wakefulness, higher levels of serotonin can reduce many depression symptoms.
What makes Zoloft® different from other SSRIs is that sertraline (the active ingredient and generic name for the same drug) also has small effects on norepinephrine and dopamine. Norepinephrine is a brain chemical that helps govern arousal, attention, and cognitive function, while dopamine can affect your movement, emotions, and your brain’s reward system.
How effective is Zoloft®?
Zoloft® is generally considered to be safe and effective, with some research suggesting that it might even have advantages over many other antidepressants. A review of 59 studies found that sertraline achieved better results than fluoxetine (Prozac®) at treating the acute stage of major depression, and was better tolerated than numerous other medications—including amitriptyline, imipramine, paroxetine and mirtazapine.
However, it’s critical to understand that not everyone responds the same way to medication, and what’s best for one person won’t necessarily be right for another. That’s one of the reasons why it’s important to talk with your healthcare provider about your options for antidepressant medication ahead of time.
Related: Understanding Your Options for Depression Medication
The side effects of Zoloft®
As with many other medications, side effects from Zoloft® are possible. Always consult a qualified healthcare professional before taking this medication, and use it only as prescribed to avoid unnecessary risks and get the maximum benefit.
Common side effects
The most likely side effects of Zoloft® include:
- Nausea
- Diarrhea or loose stool
- Tremor
- Dyspepsia (indigestion)
- Decreased appetite
- Hyperhidrosis (sweating a lot for reasons other than heat or exercise)
- Ejaculation problems
- Decreased libido
If you are experiencing side effects from Zoloft® that impact your daily life, talk to your healthcare provider. They may be able to adjust your dosage—but do not attempt to adjust your dosage by yourself.
Serious side effects
Zoloft® can also have several side effects that can be more severe. This makes it critical to check in with your healthcare provider regularly when taking this medication. Serious side effects might include:
Abnormal bleeding
Sertraline can lead to excess bleeding by impacting platelet aggregation, a condition that helps your blood clot after you’ve been injured. However, this side effect is relatively rare, and research suggests that properly adjusting the dose may help to make it avoidable.
Prolonged QT interval
Sertraline can cause this specific type of heartbeat irregularity, which can be dangerous and even fatal in certain cases. However, sertraline and other SSRIs are less likely to cause this than other popular antidepressants like citalopram—and it’s dose-dependent, which means the risk is even lower on low dosages.
Serotonin syndrome
Like other SSRIs, the sertraline in Zoloft® carries a rare risk of serotonin syndrome, a potentially life-threatening condition caused when too much serotonin builds up in your system. However, the risk for this is much higher when combining Zoloft® with other drugs that affect your serotonin levels, which your healthcare provider will likely recommend against doing.
Discontinuing Zoloft®
In some cases, you might also experience some unwanted effects if you stop taking Zoloft®—especially if you discontinue your treatment abruptly. The symptoms you might experience include:
- Nausea
- Diaphoresis (excessive sweating due to hormonal changes)
- Dysphoric mood (constant feelings of dissatisfaction)
- Irritability
- Agitation
- Vertigo
- Sensory disturbances (such as paresthesia or electric shock sensations)
- Tremor
- Anxiety
- Confusion
- Headache
- Lethargy
- Mood swings
- Sleep disorder
- Hypomania (an elevated mood that lowers your inhibitions)
- Tinnitus (ringing in the ears)
- Seizures
Because of this, most healthcare providers will recommend that you come off of Zoloft® gradually rather than stopping all at once. Remember: always talk to a healthcare professional before changing the amount of Zoloft® you take for any reason.
Adverse reactions to Zoloft® in specific populations
The sertraline in Zoloft® can also have specific risks for certain types of people. These groups include:
- Children, adolescents, and young adults with major depression: Sertraline, like other antidepressant medications, may increase suicidal ideation in young people.
- Patients over 65 years old: In seniors, sertraline can cause sodium levels in the blood to drop considerably or make the body produce too many diuretic hormones. If this happens to you, it can make your body retain too much water.
- Pregnant women: Using sertraline can cause certain cardiovascular defects in infants when taken by the mother during the first trimester, and use during the third trimester has been associated with other complications that may require hospitalization, tube feeding, or treatment with a respirator after birth.
Learn More: Sertraline (Zoloft®): Uses, Benefits, Side Effects, & More
Learn More about what to expect with Zoloft® from Lemonaid Health
Zoloft® helps many people deal with the symptoms of major depressive disorder and other mental health challenges, but some people react differently to this medication than others. That means it’s important to understand the potential side effects of this medication before talking to your healthcare provider about it.
Lemonaid Health offers private online consultations with US-based medical professionals who can answer your questions about Zoloft® and other SSRIs. We can also help you develop a personalized treatment plan for depression, which may or may not involve appropriate FDA-approved medication if clinically indicated.
Remember: your medication journey is unique, and you deserve the best possible support. Use the information above to guide future conversations about Zoloft® with medical professionals and find the path that’s right for you.
Zoloft® is a registered trademark of Pfizer, Inc. Prozac® is a registered trademark of Eli Lilly and Company.
