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Zoloft

Generic Name: sertraline (SER tra leen)
Brand Names: Zoloft

What is Zoloft?

Zoloft (sertraline) is an antidepressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Sertraline affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms.

Zoloft is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Important information

You should not use Zoloft if you also take pimozide, or if you are being treated with methylene blue injection.

Do not use Zoloft if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Before taking this medicine

You should not use Zoloft if you are allergic to sertraline, or if you also take pimozide. Do not use the liquid form of Zoloft if you are taking disulfiram (Antabuse) or you could have a severe reaction to the disulfiram.

Do not take Zoloft within 14 days before or 14 days after you take an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

To make sure Zoloft is safe for you, tell your doctor if you have ever had:

  • heart disease, high blood pressure, or a stroke;

  • liver or kidney disease;

  • a seizure;

  • bleeding problems, or if you take warfarin (Coumadin, Jantoven);

  • bipolar disorder (manic depression); or

  • low levels of sodium in your blood.

Some medicines can interact with sertraline and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, other antidepressants, or medicine for mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking Zoloft during pregnancy without your doctor's advice.

It is not known whether sertraline passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give Zoloft to anyone younger than 18 years old without the advice of a doctor. Zoloft is FDA-approved for children with obsessive-compulsive disorder (OCD). It is not approved for treating depression in children.

How should I take Zoloft?

Take Zoloft exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Zoloft may be taken with or without food. Try to take the medicine at the same time each day.

The liquid (oral concentrate) form of Zoloft must be diluted before you take it. To be sure you get the correct dose, measure the liquid with the medicine dropper provided. Mix the dose with 4 ounces (one-half cup) of water, ginger ale, lemon/lime soda, lemonade, or orange juice. Do not use any other liquids to dilute the medicine. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

Zoloft can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking Zoloft.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using Zoloft suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

Dosage Information (comprehensive)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Zoloft?

Do not drink alcohol.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with Zoloft may cause you to bruise or bleed easily.

Zoloft may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Zoloft side effects

Get emergency medical help if you have signs of an allergic reaction to Zoloft: skin rash or hives (with or without fever or joint pain); difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • a seizure (convulsions);

  • blurred vision, tunnel vision, eye pain or swelling;

  • low levels of sodium in the body - headache, confusion, memory problems, severe weakness, feeling unsteady; or

  • manic episodes - racing thoughts, increased energy, unusual risk-taking behavior, extreme happiness, being irritable or talkative.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common Zoloft side effects may include:

  • drowsiness, tiredness, feeling anxious or agitated;

  • indigestion, nausea, diarrhea, loss of appetite;

  • sweating;

  • tremors or shaking;

  • sleep problems (insomnia); or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Zoloft dosing information

Usual Adult Dose of Zoloft for Depression:

Initial dose: 50 mg orally once a day
Maintenance Dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-Obsessive Compulsive Disorder (OCD) and acute episodes of Major Depressive Disorder (MDD) require several months or longer of sustained pharmacologic therapy.

Uses:
-Treatment of MDD
-Treatment of OCD

Usual Adult Dose of Zoloft for Obsessive Compulsive Disorder:

Initial dose: 50 mg orally once a day
Maintenance Dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-Obsessive Compulsive Disorder (OCD) and acute episodes of Major Depressive Disorder (MDD) require several months or longer of sustained pharmacologic therapy.

Uses:
-Treatment of MDD
-Treatment of OCD

Usual Adult Dose of Zoloft for Panic Disorder:

Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-These conditions generally required several months or longer of sustained pharmacological therapy beyond initial treatment.

Uses:
-Treatment of panic disorder
-Treatment of posttraumatic stress disorder (PTSD)
-Treatment of social anxiety disorder (SAD)

Usual Adult Dose of Zoloft for Post Traumatic Stress Disorder:

Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-These conditions generally required several months or longer of sustained pharmacological therapy beyond initial treatment.

Uses:
-Treatment of panic disorder
-Treatment of posttraumatic stress disorder (PTSD)
-Treatment of social anxiety disorder (SAD)

Usual Adult Dose for Social Anxiety Disorder:

Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-These conditions generally required several months or longer of sustained pharmacological therapy beyond initial treatment.

Uses:
-Treatment of panic disorder
-Treatment of posttraumatic stress disorder (PTSD)
-Treatment of social anxiety disorder (SAD)

Usual Adult Dose for Premenstrual Dysphoric Disorder:

Continuous regimen:
-Initial dose: 50 mg orally once a day during the menstrual cycle
-Maintenance dose: 50 to 150 mg orally once a day during the menstrual cycle

Cyclic regimen:
-Initial dose: 50 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle
-Maintenance dose: 50 to 100 mg orally once a day

Comments:
-The dose may be increased in increments of 50 mg per menstrual cycle, increased at the onset of each new cycle; dosage adjustments may also include changes between regimens.
-If a 100 mg once daily dose has been established with the cyclic regimen, a titration step of 50 mg per day for three days should be used at the beginning of each dosing period (luteal phase of the menstrual cycle).
-The effectiveness of sertraline for longer than three months has not been systematically evaluated in controlled trials.

Treatment of premenstrual dysphoric disorder (PMDD)

Usual Pediatric Dose for Obsessive Compulsive Disorder:

6 to 12 years:
-Initial dose: 25 mg orally once a day
-Maintenance dose: 25 to 200 mg orally once a day

13 to 17 years:
-Initial dose: 50 mg orally once a day
-Maintenance dose: 50 to 200 mg orally once a day

Comments:
-The dose may be increased at intervals of at least one week.
-The potential risks versus clinical need should be assessed prior to using this drug in children and adolescents.

Use: Treatment of OCD

What other drugs will affect Zoloft?

Taking Zoloft with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with sertraline, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about Zoloft.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zoloft only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Cerner Multum, Inc. Version: 21.01.

Date modified: September 07, 2017
Last reviewed: August 09, 2017

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