Sertraline: what it treats, how to take it, side effects
Last updated September 3, 2026.
Sertraline is an SSRI antidepressant that increases serotonin, a natural substance in the brain that helps maintain mental balance. You may know it as Zoloft. It treats depression and several anxiety-related conditions, and like every antidepressant it carries a boxed warning about suicidal thoughts in younger patients that deserves to be read, not skimmed.
What does it treat?
Sertraline treats depression, obsessive-compulsive disorder, panic attacks, posttraumatic stress disorder, and social anxiety disorder, and it relieves the mood swings, irritability, bloating, and breast tenderness of premenstrual dysphoric disorder. It is sometimes used for headaches and sexual problems as well.
How do you take it?
Once a day, morning or evening, at the same time each day. The label starts treatment for depression at 50 mg once daily; your doctor may adjust the dose gradually, not more than once a week. Full benefit can take a few weeks or longer, so judge it in weeks, not days. The liquid concentrate must be diluted first - mix the measured amount with 4 ounces (half a cup) of water, ginger ale, lemon or lime soda, lemonade, or orange juice only, and drink it right away. Do not stop sertraline abruptly: suddenly stopping can cause withdrawal symptoms like nausea, sweating, dizziness, irritability, anxiety, ringing in the ears, and sleep problems, so any exit is a taper your doctor sets. Missed dose: take it when you remember unless the next one is close; never double up.
Side effects to know
- Common: nausea, diarrhea, heartburn, loss of appetite, uncontrollable shaking, sexual problems (lower sex drive, difficulty with erection, delayed or absent orgasm or ejaculation), and excessive sweating.
- Serious: the boxed warning - new or worsening depression, suicidal thoughts or actions, agitation, panic attacks, or frenzied excitement, especially in people under 24 and in the first months or after dose increases. Also serious: serotonin syndrome (agitation, hallucinations, fever, sweating, fast heartbeat, severe muscle stiffness or twitching, loss of coordination, vomiting, diarrhea), seizures, abnormal bleeding or bruising, signs of low sodium (headache, weakness, unsteadiness, confusion, memory problems), allergic reactions, and angle-closure glaucoma (eye pain, vision changes, colored rings around lights).
Who should not take it?
Never combine sertraline with MAO inhibitors - that includes having stopped one within the past two weeks, and linezolid and methylene blue count. Interactions needing a doctor's input include St. John's wort, tryptophan, aspirin, and NSAIDs like ibuprofen and naproxen. Tell your doctor about seizures, bleeding problems, high blood pressure, or heart, liver, or kidney disease (liver impairment means a lower or less frequent dose). If you are pregnant, especially in the last few months, planning pregnancy, or breastfeeding, talk to your doctor before starting. Sertraline can cause drowsiness, so no driving until you know its effects, and alcohol makes side effects worse. Children may lose appetite and weight on it - growth monitoring matters.
When is it an emergency?
Thoughts of harming or killing yourself are the emergency - call your doctor right away, call or text 988 (the Suicide and Crisis Lifeline), or go to an emergency room. Serotonin syndrome (high fever, severe muscle stiffness, confusion, fast heartbeat), seizures, and allergic reactions with facial swelling or trouble breathing need emergency care, as does sudden eye pain with vision changes. For an overdose, call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
How long does sertraline take to work?
Weeks, not days. MedlinePlus says it may take a few weeks or longer to feel the full benefit, and doctors raise doses no more than once a week. The first signs are often better sleep and energy, with mood following. Do not judge it by day three - and do not quit without a taper plan from your doctor.
Can I drink alcohol while taking sertraline?
Ask your doctor, because MedlinePlus notes alcohol can make sertraline's side effects worse - the drowsiness and dizziness in particular. If you drink, that conversation belongs with your prescriber, not the internet.
What happens if I stop sertraline suddenly?
Withdrawal, potentially: MedlinePlus lists nausea, sweating, depression, mood changes, irritability, anxiety, confusion, dizziness, headache, tiredness, seizures, ringing in the ears, numbness or tingling in the limbs, and sleep problems. The exit is a gradual taper your doctor designs - there is no safe version of quitting cold turkey.
Can I take ibuprofen with sertraline?
Not without asking first. MedlinePlus flags aspirin and NSAIDs like ibuprofen and naproxen as interacting with sertraline (the concern is bleeding risk), and St. John's wort and tryptophan too. Do not start any of them while on sertraline without checking with your healthcare provider.
Does sertraline cause weight changes?
MedlinePlus notes sertraline may decrease appetite and cause weight loss, and specifically calls this out in children - talk to your child's doctor about growth and weight monitoring. Loss of appetite is also on the common side effect list for adults.
What is the warning about serotonin syndrome?
It is a rare but dangerous overload of serotonin. MedlinePlus's symptom list: agitation, hallucinations, fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea. The risk rises when sertraline is combined with other serotonin-raising products like St. John's wort or tryptophan, which is why your pharmacist needs the full list of what you take.