Selective Serotonin Reuptake Inhibitor (SSRI)Prescription OnlyPregnancy Cat. Pregnancy Category C (first trimester); Category D (third trimester). Use during the third trimester has been associated with neonatal adaptation syndrome. Weigh risks versus benefits with prescriber; abrupt discontinuation in pregnancy is not recommended without medical guidance.FDA

Zoloft

sertraline

Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) antidepressant that works by blocking the reuptake of serotonin in the presynaptic neuron, thereby increasing serotonergic neurotransmission in the central nervous system. It was first approved by the FDA in 1991 and is indicated for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder (social phobia), and premenstrual dysphoric disorder (PMDD). Sertraline is one of the most widely prescribed antidepressants in the United States due to its favorable efficacy and tolerability profile. It is available as tablets and an oral concentrate and is approved for use in adults and pediatric patients (OCD in children aged 6 and older).

Medically reviewed by MedCentralHub Medical Review Board, Licensed Pharmacists & Physicians · May 2026

Brand names:ZoloftSertraline HClLustral

Rx Only

ZoloftOral Tablet

Quick Reference

Medicine ClassSelective Serotonin Reuptake Inhibitor (SSRI)

FDA Approved

PregnancyCategory Pregnancy Category C (first trimester); Category D (third trimester). Use during the third trimester has been associated with neonatal adaptation syndrome. Weigh risks versus benefits with prescriber; abrupt discontinuation in pregnancy is not recommended without medical guidance.

FormsTablets: 25 mg, 50 mg, 100 mg, Oral Concentrate: 20 mg/mL (dilute before use)

Check Interactions Dosage Details

Quick Facts

Active ingredient: sertraline
Medicine class: Selective Serotonin Reuptake Inhibitor (SSRI)
Brand names: Zoloft·Sertraline HCl·Lustral
Availability: Prescription only (Rx)
Pregnancy category: Pregnancy Category C (first trimester); Category D (third trimester). Use during the third trimester has been associated with neonatal adaptation syndrome. Weigh risks versus benefits with prescriber; abrupt discontinuation in pregnancy is not recommended without medical guidance.
Treats: Major Depressive Disorder·Obsessive-Compulsive Disorder·Panic Disorder·Post-Traumatic Stress Disorder·Social Anxiety Disorder·Premenstrual Dysphoric Disorder
FDA approved

What Is Zoloft?

Zoloft (sertraline) belongs to the Selective Serotonin Reuptake Inhibitor (SSRI) class of medications. It was first approved by the FDA in . This medication requires a prescription from a licensed healthcare provider.

Key Safety Information

•Always follow the dose recommended by your healthcare professional. Taking more than prescribed increases the risk of side effects including serious complications.
•Seek emergency care if you experience signs of an allergic reaction — hives, swelling, difficulty breathing, or rash. Stop the medication and call your doctor immediately.
•Some medications can increase the risk of cardiovascular events. Tell your doctor if you have high blood pressure, a history of heart attack or stroke, or any pre-existing health condition.
•Avoid or limit alcohol while taking Zoloft. Do not drink alcohol without first discussing it with your healthcare provider as it may increase adverse effects.
•Take Zoloft with food or a full glass of water if stomach upset occurs. Stop use and talk to your doctor if you experience persistent stomach pain or GI symptoms.
•Tell your doctor about all medications, supplements, and vitamins you take. Some combinations significantly increase the risk of harm.

This is a summary only. Always read the full prescribing information and consult your healthcare provider for personalized medical advice.

Uses & Indications

Zoloft is prescribed for the following conditions. Some uses are FDA-approved indications; others may be evidence-based off-label uses. Consult your healthcare provider for personalized guidance.

Treatment of major depressive disorder (MDD) in adults, including reduction of depressive symptoms and prevention of relapse

Treatment of obsessive-compulsive disorder (OCD) in adults and children aged 6 to 17 years, reducing frequency and severity of obsessions and compulsions

Management of panic disorder with or without agoraphobia, reducing the frequency and intensity of panic attacks

Treatment of post-traumatic stress disorder (PTSD) in adults, addressing intrusive symptoms, avoidance, and hyperarousal

Management of social anxiety disorder (social phobia) in adults, reducing fear and avoidance of social situations

Treatment of premenstrual dysphoric disorder (PMDD) in adults, used either daily or intermittently during the luteal phase

Off-label use for generalized anxiety disorder (GAD) as an evidence-based second-line or first-line option

Off-label management of premature ejaculation in men, leveraging the delayed ejaculation side effect

Off-label treatment of body dysmorphic disorder due to its antiobsessional properties

Off-label use in binge eating disorder as an adjunctive treatment strategy

Off-label management of chronic pain syndromes, particularly when comorbid depression is present

Off-label use in irritable bowel syndrome (IBS) with predominant anxiety or depression components

Dosage Guide

The following are general dosing guidelines only. Your actual dose should be determined by your healthcare provider based on your condition, renal/hepatic function, and other medications.

Adult Dosage

Major Depressive Disorder: Initial dose 50 mg once daily; may increase in increments of 25–50 mg at intervals of at least 1 week; usual effective dose 50–200 mg/day; maximum dose 200 mg/day. OCD: Initial 50 mg once daily; titrate to 50–200 mg/day. Panic Disorder: Initial 25 mg once daily for 1 week, then increase to 50 mg once daily; titrate up to 200 mg/day as needed. PTSD: Initial 25 mg once daily; increase to 50 mg after 1 week; range 50–200 mg/day. Social Anxiety Disorder: Initial 25 mg once daily; increase to 50 mg after 1 week; range 50–200 mg/day. PMDD: 50 mg/day either continuously or limited to the luteal phase (14 days before anticipated menstruation); may titrate up to 150 mg/day for continuous dosing or 100 mg/day for luteal phase dosing (after 3 cycles).

Pediatric Dosage

OCD (ages 6–12): Initial 25 mg once daily; titrate at weekly intervals; usual range 25–200 mg/day; maximum 200 mg/day. OCD (ages 13–17): Initial 50 mg once daily; usual range 50–200 mg/day; maximum 200 mg/day. Not approved for MDD, panic disorder, PTSD, social anxiety disorder, or PMDD in patients under 18 years of age.

Available Forms

Tablets: 25 mg, 50 mg, 100 mgOral Concentrate: 20 mg/mL (dilute before use)

Available Strengths

View Complete Dosage Guide

Side Effects

Common

Nausea (26%): most common, usually transient and improves after first 1–2 weeks
Diarrhea/loose stools (20%): often dose-dependent
Insomnia (21%): difficulty falling or staying asleep, particularly early in treatment
Dry mouth (16%): reduced salivary flow
Somnolence/drowsiness (13%): some patients experience sedation rather than insomnia
Dizziness (12%): may be postural; caution when rising quickly
Tremor (11%): fine hand tremor, usually mild

Serious

Suicidality — Black Box Warning: Increased risk of suicidal thinking and behavior in children, adolescents, and young adults (up to age 24) during initial treatment; monitor closely, especially in the first 1–4 weeks
Serotonin syndrome: Life-threatening condition caused by excess serotonergic activity; symptoms include hyperthermia, rigidity, myoclonus, autonomic instability, mental status changes; risk increased with concomitant serotonergic agents
Activation of mania/hypomania: May precipitate a manic or mixed episode in patients with undiagnosed bipolar disorder; screen for bipolar disorder before initiating
Seizures: Sertraline lowers the seizure threshold; use with caution in patients with a seizure disorder or history of seizures
Hyponatremia/SIADH: Clinically significant hyponatremia reported, especially in elderly patients; may present as confusion, weakness, seizures
QTc prolongation: Rare but reported at high doses; caution in patients with cardiac risk factors or concomitant use of QT-prolonging drugs
Abnormal bleeding: Impaired platelet aggregation due to serotonin depletion; risk increased with concurrent NSAIDs, aspirin, or anticoagulants; can present as GI bleeding or ecchymosis

Rare

Angle-closure glaucoma: Pupillary dilation caused by sertraline may trigger acute angle-closure glaucoma in anatomically predisposed individuals
Pulmonary hypertension of the newborn (PPHN): Associated with SSRI use in late pregnancy; risk approximately 6 per 1,000 neonates
Stevens-Johnson syndrome/toxic epidermal necrolysis: Very rare severe cutaneous adverse reactions reported
Agranulocytosis/aplastic anemia: Extremely rare hematologic adverse events
Hepatotoxicity: Rare cases of clinically significant liver injury including hepatitis and elevated transaminases
Neuroleptic malignant syndrome (NMS)-like reactions: Rare; presents with hyperthermia, muscle rigidity, altered consciousness
Hallucinations/psychosis: Rare in patients without underlying psychotic disorder

View All Side Effects

Medicine Interactions

Always inform your healthcare provider and pharmacist about ALL medications you take, including prescriptions, OTC medicines, vitamins, and supplements.

MajorModerateMinor

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Warnings & Contraindications

⚠ Boxed Warning

BLACK BOX WARNING — Suicidal ideation in young patients: Antidepressants increase the risk of suicidal thoughts and behaviors in pediatric patients and young adults (up to age 24); this risk must be balanced against clinical need; monitor all patients closely for clinical worsening, agitation, unusual behavior, or suicidality, especially during the first 4 weeks

Serotonin syndrome: Do not use sertraline with MAO inhibitors or within 14 days of stopping an MAOI. Allow 14 days after stopping sertraline before starting an MAOI. Serotonin syndrome can be life-threatening; discontinue immediately if suspected

Screening for bipolar disorder: Prior to initiating treatment, screen patients for personal or family history of bipolar disorder, mania, or hypomania; sertraline monotherapy may precipitate a manic episode in undiagnosed bipolar patients

Angle-closure glaucoma: Sertraline can cause pupillary dilation (mydriasis) that may trigger an acute angle-closure attack in patients with narrow-angle anatomy; evaluate patients for this risk before initiating

Hyponatremia: SIADH and hyponatremia have been reported, primarily in elderly patients and those receiving diuretics; discontinue if symptomatic hyponatremia occurs

Bleeding risk: Impaired platelet aggregation can result in abnormal bleeding events ranging from bruising to severe GI hemorrhage; the risk is compounded by concurrent use of NSAIDs, aspirin, or anticoagulants

Activation or worsening of anxiety: Some patients may experience increased anxiety, agitation, or panic attacks early in treatment; lower initial doses (25 mg) can help mitigate this in anxiety disorders

Discontinuation syndrome: Do not abruptly stop sertraline; gradually taper the dose over several weeks to minimize the risk of discontinuation symptoms such as dizziness, paresthesias, irritability, and flu-like symptoms

Use in pregnancy (third trimester): Neonates exposed to SSRIs in late pregnancy may experience complications including respiratory distress, cyanosis, apnea, hypoglycemia, and neonatal withdrawal syndrome; weigh risks and benefits carefully

Hepatic impairment: Sertraline is extensively metabolized by the liver; use with caution in patients with hepatic impairment and use lower doses; avoid in severe hepatic impairment

Sexual dysfunction: Sertraline commonly causes sexual side effects including decreased libido, delayed ejaculation, and anorgasmia; these may persist and should be discussed with patients before starting treatment

Weight changes: Sertraline may cause decreased appetite and weight loss during short-term treatment; long-term use is associated with weight gain in some patients; monitor weight throughout treatment

How Zoloft Works

Sertraline exerts its antidepressant and anxiolytic effects primarily by selectively inhibiting the serotonin reuptake transporter (SERT) on presynaptic neurons, preventing the reuptake of serotonin (5-hydroxytryptamine, 5-HT) from the synaptic cleft and thereby increasing the concentration of serotonin available to bind postsynaptic receptors. This enhanced serotonergic neurotransmission in limbic, cortical, and subcortical brain regions is believed to underlie improvements in mood, anxiety, and obsessive-compulsive behaviors over time. Sertraline has minimal affinity for adrenergic, cholinergic, GABA, dopaminergic, histaminergic, benzodiazepine, or serotonin receptors, which accounts for its relatively favorable tolerability compared to older antidepressants such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

Pharmacokinetics

Pregnancy & Breastfeeding Safety

Pregnancy Category C (first trimester); Category D (third trimester). Use during the third trimester has been associated with neonatal adaptation syndrome. Weigh risks versus benefits with prescriber; abrupt discontinuation in pregnancy is not recommended without medical guidance.

FDA Pregnancy Category Pregnancy Category C (first trimester); Category D (third trimester). Use during the third trimester has been associated with neonatal adaptation syndrome. Weigh risks versus benefits with prescriber; abrupt discontinuation in pregnancy is not recommended without medical guidance.

Consult your healthcare provider.

Full Pregnancy Information

Breastfeeding

Many medications pass into breast milk in varying amounts. Before using Zoloftwhile breastfeeding, discuss the benefits and risks with your healthcare provider or pharmacist — they can weigh your dose, your infant's age, and available lactation safety data to find the safest option for you and your baby.

Storage & Handling

Store at controlled room temperature between 20°C and 25°C (68°F and 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F). Protect from light and moisture. Keep the oral concentrate tightly closed. Keep all sertraline formulations out of reach of children. Do not store in the bathroom. Discard unused oral concentrate after 28 days of opening. Do not flush medications down the toilet unless instructed; use a drug take-back program when available.

Frequently Asked Questions

How long does it take for Zoloft to work?

Most patients begin to notice some improvement in sleep, energy, and appetite within 1–2 weeks of starting Zoloft, but the full antidepressant effect on mood typically takes 4–6 weeks of consistent use. For anxiety disorders such as OCD or PTSD, it may take 8–12 weeks to experience significant symptom relief. It is important to continue taking the medication as prescribed even if you do not feel immediate improvement.

What are the most common Zoloft drug interactions I should know about?

The most serious Zoloft drug interactions involve MAO inhibitors (such as phenelzine or tranylcypromine), which can cause a life-threatening reaction called serotonin syndrome — these combinations are strictly contraindicated. Zoloft also interacts with blood thinners like warfarin (increasing bleeding risk), NSAIDs and aspirin (increasing GI bleeding risk), other antidepressants and serotonergic medications, and certain heart medications that affect the QT interval. Always inform your doctor and pharmacist of all medications, supplements, and herbal products you are taking, including St. John's Wort.

Can I drink alcohol while taking Zoloft?

While sertraline does not dramatically amplify the sedative effects of alcohol, drinking alcohol is generally not recommended when taking Zoloft. Alcohol is a CNS depressant that can worsen depression and anxiety symptoms, counteract the therapeutic benefits of the medication, and increase the risk of side effects such as dizziness and impaired judgment. If you choose to drink, do so in strict moderation and discuss it with your doctor.

Will Zoloft cause weight gain?

During the first few months of treatment, Zoloft may actually cause slight weight loss due to decreased appetite and nausea. However, long-term use — particularly beyond 6 months — has been associated with modest weight gain in some patients. Weight changes vary widely among individuals. Maintaining a balanced diet and regular physical activity can help manage weight while on sertraline.

Is it safe to stop taking Zoloft suddenly?

No. Abruptly stopping Zoloft can cause discontinuation syndrome, which includes symptoms such as dizziness, electric shock-like sensations (brain zaps), irritability, nausea, flu-like symptoms, and anxiety. These symptoms are not dangerous but are very uncomfortable. Always work with your doctor to gradually taper your dose over several weeks or months before stopping completely.

Can Zoloft be taken during pregnancy?

Zoloft is classified in Pregnancy Category C for the first trimester and Category D for the third trimester. Use during late pregnancy has been associated with neonatal adaptation syndrome in newborns. However, untreated depression or anxiety during pregnancy also carries significant risks. This is a complex decision that should be made in close consultation with your obstetrician and psychiatrist, weighing the risks of the medication against the risks of untreated illness.

What should I do if I miss a dose of Zoloft?

If you miss a dose, take it as soon as you remember — unless it is almost time for your next scheduled dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time to make up for a missed dose. Consistent daily dosing helps maintain stable blood levels and maximizes effectiveness.

Can Zoloft be taken with food?

Yes, and it is often recommended to take Zoloft with food. Taking it with a meal can reduce nausea, which is the most common early side effect. There is no food interaction that significantly affects sertraline's effectiveness (unlike MAOIs, which require dietary restrictions). However, if you take the oral concentrate form, it must be diluted in water or certain juices immediately before drinking.

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Comprehensive Guide to Zoloft

## What Is Zoloft (Sertraline)?

Zoloft is the brand name for sertraline hydrochloride, a prescription antidepressant belonging to the class of drugs known as selective serotonin reuptake inhibitors, or SSRIs. First approved by the U.S. Food and Drug Administration (FDA) in 1991, Zoloft is one of the most widely prescribed psychiatric medications in the United States and throughout the world.

Sertraline is approved to treat a range of mental health conditions in adults, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD). In children aged 6 to 17, it is approved specifically for OCD. The medication is also used off-label for conditions such as generalized anxiety disorder, body dysmorphic disorder, and premature ejaculation.

Generic sertraline became available in the United States in 2006, making it one of the most affordable antidepressants on the market. It is available as tablets in 25 mg, 50 mg, and 100 mg strengths, as well as an oral liquid concentrate of 20 mg per milliliter.

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## How Does Zoloft Work?

Zoloft works by selectively blocking the serotonin reuptake transporter (SERT), a protein on the surface of nerve cells responsible for removing serotonin from the synaptic cleft — the space between two neurons — and transporting it back into the presynaptic neuron.

Serotonin (also known as 5-hydroxytryptamine or 5-HT) is a neurotransmitter that plays a critical role in regulating mood, emotion, sleep, appetite, and cognition. By blocking its reuptake, sertraline allows serotonin to remain in the synapse longer, enhancing its effect on postsynaptic receptors. Over time, this increased serotonergic signaling is believed to normalize the brain circuits involved in mood and anxiety regulation.

Unlike older antidepressants such as tricyclics and MAO inhibitors, sertraline has very little activity at other receptor types — including histamine, acetylcholine, and dopamine receptors — which explains its more favorable side effect profile.

It is important to understand that sertraline does not work immediately. Mood-related benefits typically emerge gradually over 4–6 weeks, and in some conditions like OCD and PTSD, the full effect may take up to 12 weeks.

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## Summary

Zoloft (sertraline) is a well-established, FDA-approved SSRI with a broad range of indications spanning depression, anxiety, OCD, PTSD, and PMDD. Its favorable tolerability profile, once-daily dosing, and availability as a low-cost generic make it one of the most used antidepressants worldwide. Like all medications, it requires careful attention to drug interactions — most importantly with MAO inhibitors and other serotonergic agents — as well as monitoring for serious adverse effects including suicidality in young patients, serotonin syndrome, and bleeding complications. With appropriate use and regular follow-up with a healthcare provider, sertraline can provide meaningful, lasting relief for a wide range of mental health conditions.

Sources & References

• FDA Prescribing Information — Official labeling and package insert for Zoloft
• U.S. National Library of Medicine — MedlinePlus drug information
• American Hospital Formulary Service (AHFS) — Clinical pharmacology monograph
• PubMed / MEDLINE — View clinical studies

Last reviewed by MedCentralHub Medical Review Board · MedCentralHub Editorial Policy

Medical Disclaimer

The information on this page is for educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult your doctor, pharmacist, or qualified healthcare provider before starting, stopping, or changing any medication.