If you take Zoloft or its generic form, sertraline, you are not alone. Zoloft is the brand name for the most commonly prescribed medication for mental health - and one of the most widely prescribed medications overall. It has become even more popular lately, with 38 million prescriptions written in 2018, up from 26 million in 2008 - a 46% increase. But even those of us who take Zoloft don’t always know what it really is, how it works, its potential side effects, how we should and shouldn’t take it. Let’s take a closer look.
What is Zoloft?
Zoloft is an antidepressant that falls into a class of prescription medications called SSRIs or selective serotonin reuptake inhibitors. It is often prescribed to treat depression, and major depressive disorder. But despite the name antidepressant, they can be prescribed for conditions beyond depression. Zoloft, for example, is also prescribed to treat anxiety, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), panic disorder, panic attacks, premenstrual dysphoric disorder, (PDD) and other medical conditions.
Other antidepressants include: Lexapro (generic: escitalopram), Wellbutrin (generic: bupropion), Celexa (generic: citalopram), Prozac (generic: fluoxetine), Cymbalta (generic: duloxetine), Effexor (generic: venlafaxine), Paxil (generic: paroxetine), Remeron (generic: mirtazapine), Pristiq (generic: desvenlafaxine) and Viibryd (generic: vilazodone). Altogether, over 13% of adult Americans, and 18% of adult American women take antidepressants. That’s over 40 million people!
What is the difference between Zoloft and generic Sertraline?
According to The Food and Drug Administration (FDA) Zoloft and generic sertraline are equally effective. If you find that the generic form is not working as well for you, ask your doctor.
How does Zoloft work?
Our bodies produce a chemical called serotonin, a neurotransmitter which carry messages across our nerve cells, including those in our brains. It is thought that serotonin can stabilize our moods, and help with sleep, appetite, and digestion. But after carrying messages, some serotonin gets absorbed into our nerve cells. As a result, some of us don’t have enough serotonin. Zoloft helps block that absorption, freeing up more serotonin, and improving our ability to send messages. In many cases, Zoloft can improve our mood, give us more energy, help us sleep better, restore our appetites, and decrease anxiety.
Am I taking the right dosage of Zoloft?
When you were initially prescribed Zoloft, you (hopefully) worked with a board-certified psychiatrist or psychiatric nurse practitioner, or other medical professional with specialized training in psychiatric medication - like those on our team at Minded. For many of us, that process involved discussing our symptoms, medical history, and other important factors. Then, with the help of that psychiatric expert, we started with a low dose and then experimented with dosage until we found the combination that made us feel better, happier, and more like the best version of ourselves. Of course, our bodies, minds and circumstances change over time, and it can be necessary to adjust our Zoloft. In some cases it could also make sense to switch to or augment with other medications, or to even discontinue using Zoloft. Just keep in mind that if you’re considering any of those options, don’t just wing it - work closely with your psychiatric care provider. People who stop taking Zoloft without gradually decreasing their dosages can experience withdrawal-like symptoms including nausea, dizziness, insomnia, etc.
Am I getting the right care?
Not all medical professionals that prescribe antidepressants are created equal. It’s important that the person who prescribes your Zoloft has expertise in psychiatric care, that they are compassionate and non-judgmental, and that they take responsibility for monitoring your condition - not just during your visits, but also between visits. They should even reach out if you discontinue seeing them. Maybe you’ve switched providers because you moved, changed insurance, or aren’t satisfied with your care. But in any case, that should raise a red flag just in case you’ve taken it upon yourself to discontinue taking your Zoloft - or have fallen behind. If you feel you’re not being properly cared for, consider changing your provider. We named our company Minded for this very reason. We take responsibility for people under our care during and between visits - and even if they decide to leave us, we reach out to make sure they haven’t just stopped taking their Zoloft.
What should I tell my doctor before taking Zoloft?
Before starting Zoloft, tell your healthcare provider if you have a history of liver problems, heart problems, bipolar disorder or mania, kidney problems, or have had seizures or convulsions, low sodium levels in your blood, a history of a stroke, high blood pressure or have had bleeding problems.
How long to take Zoloft?
Most people who find that Zoloft or other antidepressants make them feel better tend to stay on the medications over the long term. Many others, feeling better, try to stop taking their medications, only to realize they revert back to what drove them to start in the first place, and resume treatment. There’s been limited research into whether there’s harm in taking Zoloft or other antidepressants for the long term. Some people claim they worry about long term use because of social stigma - or because they think relying on medication to feel better is somehow a sign of weakness. But over 15 million adults have taken antidepressants for five years or more. And 15% of people who take antidepressants stay on them for ten years or more.
Zoloft side effects
People taking antidepressants can experience side effects. The most common side effects of Zoloft include: Nausea, loss of appetite, diarrhea, indigestion, increased sweating, shaking, agitation, insomnia, sexual side effects such as decreased libido, fatigue, and anxiety.
People taking Zoloft and other antidepressants can experience unwanted side effects, like nausea, weight gain, decreased libido, fatigue, diarrhea, or sleep problems. In most cases, these improve within a few weeks. But for some people, certain side effects may continue. If you experience allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue, you should contact your doctor or medical professional immediately.
What is the right dose of Zoloft for me?
It is very important to take the right dose of Zoloft. If you take too little, it might not help you feel better. If you take too much, it might cause unwanted side effects. When initially prescribed, you and your doctor most likely tried different dosages - and possibly different medications, until you found the right dosage. However, in some cases you may find that your dosage is no longer making you feel your best, in which case you should ask your Minded Care team whether an adjustment is appropriate. At Minded, we find that most people take between 25 and 100 milligrams per day, although higher dosages are appropriate in some cases.
When should I take Zoloft?
Zoloft is designed to be taken once a day. You can take it at any time of the day, but it’s best to take it at the same time every day. If you find Zoloft makes you drowsy, you may prefer to take it in the evening. If Zoloft makes it difficult for you to fall asleep, try taking it in the morning. If Zoloft tends to give you unwanted sexual side effects, you may choose to take it several hours before or after sex. Note: if sexual side effects are persistent, ask your doctor about other options, such as different dosages, different mental health medications, or non-mental health medications that may improve your sex.
What if I miss a dose of my Zoloft?
If you forget to take a dose of Zoloft, take it as soon as you realize you have missed it that same day. If you miss a day, just resume taking your next dose the following day - don’t take two doses to “catch up” on the missed dose.
Can I take myself off Zoloft?
If you feel you’d like to discontinue using Zoloft, it’s important to work with your doctor or healthcare professional. If appropriate, they will likely reduce your dosage gradually and should monitor your progress. If you stop taking Zoloft abruptly, you could experience unpleasant symptoms.
What about sex and Zoloft?
SSRI medications can affect sexuality in a number of different ways. For one, they can reduce a person’s interest in having sex. They can also make it difficult to become aroused, sustain arousal, and reach orgasm.
Sexual dysfunction for women can include delayed lubrication. For men, it can include delayed ejaculation and difficulty getting an erection. In general, all of these symptoms tend to become more common with age.
Pregnancy and Zoloft
Ask your doctor or healthcare provider before taking Zoloft while pregnant or breastfeeding. While many mental health medications can pose high risks in these cases, Zoloft tends to be one of the few antidepressants with lower risk, along with Celexa (generic: citalopram). But consult your healthcare provider anyway.
Interactions with other medications
Zoloft, like all medications, can interact with other medications. These drug interactions may increase the level of Zoloft in your body, stop your medications from working properly or cause a range of unwanted and potentially dangerous side effects.
This means that when your healthcare provider prescribes Zoloft for you, it is important to tell your doctor if you are taking any other medications or certain medical conditions. In particular, there are three types of medication about which you have to be very careful:
You should not take Zoloft in tandem with any of the medications known as Monoamine Oxidase Inhibitors (MAOIs). MAOIs are used to treat depression, and when they are taken in tandem with Zoloft, they can cause a dangerous problem called Serotonin Syndrome. Be sure to tell your doctor if you are taking any of the MAOIs or any other type of psychiatric medication. Taking a combination of SSRIs and MAOIs can lead to symptoms such as confusion, high blood pressure, hyperactivity, or coma.
Given that Zoloft itself can increase the risk of bleeding do not take Zoloft together with any blood thinners. This would include (1) aspirin and (2) any of the medications that are taken to thin blood after a stroke or heart attack.
Do not take Pimozide and Zoloft together. Pimozide is a medication that is used to treat psychotic conditions. If you take both of these medications together, you will risk developing a serious heart arrhythmia that is potentially lethal.
Other frequently asked question (FAQs) about Zoloft
How should Zoloft be taken?
Zoloft is designed to be taken once a day, and you can take it at the time of the day that suits you best. The important thing is to take it at the same time every day. It can be taken with or without food. If your Zoloft makes you drowsy, take it just before you go to bed. If, on the other hand, your Zoloft is keeping you awake at night, take it in the morning.
How long does it take Zoloft to work?
On average, it takes 6-8 weeks to feel the full beneficial effects of Zoloft, but it can take less or more time. Some people report that they start to feel better after just two weeks.
Is it safe to drink alcohol with Zoloft?
This is simple. Never drink alcohol while you are taking Zoloft.
Can Zoloft cause weight gain?
Zoloft can cause both weight gain and weight loss. It depends. All antidepressants can cause weight gain, but several studies show that Zoloft causes less weight gain than other antidepressants.
Does Zoloft alter the effectiveness of birth control pills?
Zoloft does not affect birth control pills, and you can take Zoloft without increasing the probability of getting pregnant.
How long do the side effects of Zoloft last?
Diarrhea and nausea are common side effects of Zoloft. They usually occur only during the first few weeks of taking the medication. It’s unusual for diarrhea to last for more than a few days.
Most of the other side effects of Zoloft are also limited to the first few weeks. They usually become less apparent over the course of the first several weeks as your body adjusts to Zoloft.
If a side effect persists, be sure and talk to your doctor about it. Adjusting your dose may eliminate it.
Is it safe to drive after taking Zoloft?
In general, yes, but if you feel dizzy, sleepy, or fatigued while taking Zoloft, you should not drive a car or ride a motorcycle.
How long can you stay on Zoloft?
Extensive research has shown that it is safe to take Zoloft for long periods of time. Many people have taken Zoloft safely for years. If your depression lifts while you are taking Zoloft, the usual practice is to keep taking it for one more year after your symptoms end.
Can Zoloft be bought over the counter?
No. Zoloft is a prescription drug, which means you will need a prescription from a healthcare provider to take either Zoloft or generic Sertraline.
Getting Zoloft and managing prescription medications from Minded
Minded is reimagining the traditional psychiatrist experience. Minded is 100% online, and open every day. We’re designed to be quick, easy, and affordable to most people - even without insurance. Our board-certified psychiatrists and psychiatric nurse practitioners write prescriptions, as well as adjust prescriptions. In addition to being professional, the Minded care team is also considerate, compassionate, non-judgmental - and relatable.
To start using Minded, go to our website on your phone or computer. And answer a few questions about your health and the medication you take. That only takes 4-5 minutes. Your answers help our Care Team learn more about you, so it’s faster and easier for them to assess whether the medications you take now remain appropriate. In most cases they’ll schedule a 5-10 minute video call, so you can get to know the psychiatrists and psychiatric nurse practitioners who will be on your Care Team, and they can ask any remaining questions. If appropriate, they’ll prescribe your medications. Then you can decide whether to have them delivered through one of our pharmacy partners or to have Minded send the prescription to your local pharmacy. From there, Minded takes responsibility for managing your ongoing care. We remind you when it’s time to renew your prescriptions or order refills, and we’re here for you whenever you have questions, or if you want to adjust or go off your medication.
About the authors
This article was written by two co-founders of Minded. David Ronick takes an antidepressant daily, and controlled medications for anxiety and sleep occasionally, as-needed. Chris Dennis, MD is a board-certified psychiatrist who has practiced for over twenty years and is licensed in 35 states.
The information contained in this article is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription medication or following any treatment or regimen. Minded makes no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the article.