Sertraline (Zoloft)
One of the most commonly prescribed SSRIs. Generally well tolerated, effective for several conditions, and compatible with long-term use for most people.
What it's used for
Major depressive disorder, generalized anxiety, panic disorder, social anxiety, PTSD, OCD, and premenstrual dysphoric disorder.
Typical dosing (adults)
- Starting: 25-50mg once daily.
- Range: 50-200mg daily.
- Take with food to reduce nausea, morning or evening consistently.
What to expect
GI side effects (nausea, loose stools) are most common in week 1-2 and usually fade. Full therapeutic effect takes 4-8 weeks. Don't stop abruptly — taper under guidance to avoid discontinuation symptoms.
Key interactions
- MAO inhibitors: contraindicated — serotonin syndrome risk.
- Other serotonergic drugs (tramadol, triptans, St. John's Wort, linezolid): major — serotonin syndrome risk.
- NSAIDs, aspirin, warfarin: moderate — increased bleeding risk.
- QT-prolonging drugs: moderate — arrhythmia risk at higher doses.
- Alcohol: generally not recommended while starting.
Common side effects
Nausea, diarrhea, insomnia or drowsiness, sexual side effects (delayed orgasm, reduced libido), slight sweating. Serious but rare: serotonin syndrome, hyponatremia, suicidal thoughts in those under 25 (monitor carefully early on).
Who should be cautious
- Bipolar disorder (can trigger mania without a mood stabilizer).
- Seizure disorders.
- Pregnancy — risk/benefit discussion with prescriber.
What to ask your pharmacist
- Does sertraline interact with my other medications?
- When should I expect improvement?
- If I want to stop someday, how do I taper safely?