Side Effects of Zoloft (Sertraline)

Zoloft (sertraline) is an antidepressant used to treat depression and anxiety and one of the most prescribed psychiatric drugs in the U.S. Some of its common side effects include fatigue, nausea, sleep issues, and sexual problems. While severe side effects are less common, they can occur in some individuals.

Knowing what to expect and finding ways to cope can help you better manage these side effects. Read on to learn more about the most common side effects of Zoloft and ways to reduce them, as well as some of Zoloft's less common but potentially more severe side effects that require medical attention.

Common Zoloft Side Effects

As with all medications, Zoloft may cause certain unwanted side effects. The adverse effects experienced most frequently when taking Zoloft include:

• Decreased appetite
• Dizziness
• Dry mouth
• Fatigue
• Gastrointestinal issues (nausea, diarrhea, upset stomach)
• Increased sweating
• Insomnia
• Sexual issues, including loss of libido and inability to ejaculate or orgasm
• Tremors
• Weight gain

Nausea, diarrhea, and insomnia are the most common Zoloft side effects. Others are less common but may also be distressing. Let's take a closer look at some of these effects and ways to help deal with them.

Nausea

Nausea is the most common side effect of Zoloft, affecting around one in four people who take sertraline. While it occurs most frequently, this side effect also typically goes away over time. 

Nausea is often the greatest when you first begin taking this medication or if your physician increases your dose. To cope with Zoloft-related nausea, you may find it helpful to take the medication with food. You can also try nausea relief remedies such as drinking ginger tea. 

Trouble Sleeping

Around one in five people experience insomnia or trouble sleeping as a side effect of Zoloft. However, some strategies can help people manage this side effect, such as taking the medication in the morning. 

If you do find that you have difficulty falling or staying asleep while taking Zoloft, practicing good sleep habits can also be helpful. Go to sleep at the same time each night and limit your caffeine intake during the day, especially in the afternoon and evenings.

Sexual Side Effects

Sexual side effects of sertraline include a loss of desire or sex drive and difficulties related to arousal and orgasm. People can sometimes minimize these symptoms by taking Zoloft immediately after sex or adjusting treatment with their physician's advice.

Weight Gain

Another potential side effect of Zoloft is weight gain. A long-term study published in the British Medical Journal (BMJ) in 2018 found that for up to six years after starting treatment, people taking antidepressants such as Zoloft were 21% more likely to experience at least a 5% weight gain than those not taking the drugs. Participants were also 29% more likely to move up a weight category—from normal to overweight or overweight to obese—than those not on antidepressants.

While experts are still trying to figure out the link, some theories exist. For one, SSRIs can trigger changes in your metabolism, increasing appetite and causing the body to burn off calories less efficiently. Also, many people lose their appetite and lose weight when they’re depressed, so weight gain may just be a result of them feeling better when they’re on the drug.

Less Common Zoloft Side Effects

While less common, there are some serious side effects associated with Zoloft use. For example, in some cases, Zoloft may trigger or exacerbate psychiatric symptoms.

Call your physician if you experience any new or worsening psychiatric symptoms, including:

• Agitation
• Anxiety
• Hallucinations
• Impulsiveness
• Memory loss
• Symptoms associated with psychosis, major depression, or mania

Seek immediate medical assistance if you experience any of the following:

• Black or bloody stools
• Chest pain
• Fainting
• Fast or irregular heartbeat
• Fever over 100^o F
• Seizure
• Severe or persistent headache
• Skin reactions
• Suicidal thoughts

Zoloft Side Effects in Children and Adolescents

When prescribed in children or adolescents, Zoloft can cause a slightly different range of side effects, some of which are less common in adults. Advise your pediatrician if your child experiences any of the following:

• Abnormal heartbeat
• Bladder control issues
• Bleeding issues, such as throwing up blood or blood in urine or stools
• Major weight changes
• Memory issues or feeling confused
• Muscle twitching, stiffness, or tremors
• Seizures
• Swollen, blistered, or peeling skin
• Trouble with balance

Serotonin Syndrome

Zoloft belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). It works by preventing the reabsorption of serotonin (the "feel good" neurotransmitter) so more is available in the system.

Because Zoloft affects serotonin levels in the brain, it also has the potential to cause serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition in which serotonin levels become too high. Its symptoms include:

• Agitation
• Confusion
• Diarrhea
• Irregular or rapid heartbeat
• Loss of consciousness
• Muscle twitching or rigidity
• Seizures
• Shivering
• Sweating

This condition is more likely to occur if you take Zoloft with another medication that affects serotonin levels, such as a different antidepressant or a supplement such as St. John's wort. Some other psychiatric medications, painkillers, antibiotics, supplements, and drugs such as amphetamines, cocaine, and LSD can also increase serotonin.

Coping With Zoloft Side Effects

Side effects from Zoloft tend to be manageable and often go away on their own as your body adjusts to your medication. It typically takes several weeks for an antidepressant to begin working, so it is important to give it this time.

The type and severity of Zoloft side effects can vary from person to person. Most symptoms tend to be minimal and generally improve over time. Common side effects often last one to two weeks until you get used to your medication.

Talk to your physician about your symptoms if you are concerned about side effects. They can suggest ways to cope or make medication changes if needed.

If you find you are unable to cope with the side effects, call your healthcare provider immediately. There may be strategies they can offer (including a dose adjustment or adjunctive therapies) to help you better adjust to the prescribed treatment.

Not only might you undermine the goals of treatment, but you may also experience a condition known as antidepressant discontinuation syndrome (ADS), which can manifest with symptoms of sertraline withdrawal (including nausea, dizziness, irritability, and abnormal sensations). ADS can occur as early as six weeks after starting therapy.

Instead, it's often best to wean off Zoloft. This involves taking smaller and smaller doses over time until you eventually stop taking this medication altogether.