Sertraline

Key facts

• Sertraline (sold as Zoloft and as generics) is an SSRI, a selective serotonin reuptake inhibitor, used for depression, panic disorder, OCD, PTSD and social anxiety.
• You take it once daily, with or without food; it can take 2 to 6 weeks to reach its full effect.
• In people under 25, sertraline can increase suicidal thoughts and behaviour, especially in the first weeks of treatment or after a dose change. Anyone starting it should be watched closely for new agitation or self-harm thoughts.
• Seek urgent care for a fast heart rate, high fever, confusion or muscle rigidity: these can signal serotonin syndrome.

What sertraline treats

Sertraline treats major depressive disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder and premenstrual dysphoric disorder. It eases persistent low mood, intrusive or repetitive thoughts, panic attacks and excessive fear of social situations.

How sertraline works

Nerve cells release serotonin, a chemical messenger involved in mood, and then reabsorb it. Sertraline blocks that reabsorption (reuptake), so more serotonin stays available between nerve cells. This shift builds gradually over weeks and is thought to ease depression and anxiety.

Before you take it

• Never take sertraline within 14 days of a monoamine oxidase inhibitor (MAOI); the combination can cause serotonin syndrome, which can be fatal.
• Tell your prescriber if you have bipolar disorder, a seizure history, liver disease, glaucoma, or take blood thinners, other serotonergic drugs, or NSAIDs regularly (sertraline raises bleeding risk).
• Do not stop sertraline suddenly. Stopping abruptly can cause dizziness, electric-shock sensations, irritability and flu-like symptoms; your prescriber will taper the dose down gradually.
• If you are pregnant, planning pregnancy or breastfeeding, discuss the risks and benefits with your prescriber before starting or stopping.

Side effects

Common effects, often easing after the first few weeks: nausea, dry mouth, insomnia or drowsiness, sweating and reduced sex drive.

Stop and seek urgent medical care for any of these:

• New or worsening suicidal thoughts, especially if you are under 25.
• Agitation, high fever, fast heartbeat, muscle twitching or confusion (serotonin syndrome).
• Unusual bleeding or bruising.
• Severe rash, swelling or difficulty breathing.

Safety essentials

• Sertraline carries a warning for increased suicidal thinking in people under 25, particularly in the first weeks of treatment and after any dose change. Anyone around a young person starting this drug should watch for agitation or talk of self-harm.
• Never combine sertraline with an MAOI, and tell every prescriber about all other serotonergic medicines you take (triptans, tramadol, other antidepressants, St John's wort) to avoid serotonin syndrome.
• Taper off slowly under medical guidance rather than stopping abruptly.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.