What are the common side effects of Zoloft (sertraline)? How do you avoid and manage them? Get answers on Zoloft side effects, warnings, and drug interactions.

Common Side Effects of Sertraline (Zoloft)

When taking the antidepressant sertraline, also known by its brand name Zoloft, patients may experience a variety of potential side effects. The most common side effects of sertraline include:

• Nausea
• Diarrhea
• Constipation
• Difficulty sleeping
• Dry mouth
• Heartburn or indigestion
• Loss of appetite
• Weight changes (loss or gain)
• Dizziness
• Excessive tiredness
• Headache
• Nervousness
• Changes in sex drive
• Erectile dysfunction or delayed ejaculation
• Excessive sweating

When Do Zoloft Side Effects Subside?

Many of the common side effects experienced when starting sertraline can go away after a few weeks as the body adjusts to the medication. “Sertraline itself takes about a month to start working, and many of the mild side effects diminish after your body has adjusted to the medication,” explains Dr. David Nazarian, a primary care physician.

It’s important to track any side effects you experience and keep your healthcare provider informed so they can effectively monitor your reaction and adjust the medication as needed. Be sure to inform your doctor if any side effects are severe, worsening, or do not go away.

Serious Side Effects of Sertraline

While less common, there are some more severe side effects of sertraline that require immediate medical attention, such as:

• Abnormal bleeding or bruising
• Agitation
• Confusion
• Fever, sweating, shivering
• Hallucinations
• Hives or rash
• Loss of coordination
• Muscle stiffness or twitching
• Nausea, vomiting, or diarrhea
• Rapid heartbeat
• Seizures
• Swelling
• Suicidal thoughts
• Trouble breathing
• Uncontrollable shaking of a body part

Avoiding Zoloft Withdrawal Symptoms

It is crucial not to stop taking sertraline abruptly, as this can lead to withdrawal symptoms. Instead, work closely with your healthcare provider to develop a plan to slowly taper off the medication. Withdrawal symptoms can include:

• Irritability and mood swings
• Nausea
• Dizziness
• Vomiting
• Insomnia
• Nightmares
• Headache
• Tingling or prickling sensations on the skin

These withdrawal symptoms, collectively known as antidepressant discontinuation syndrome, require immediate medical attention.

Sertraline Warnings and Precautions

There are several important warnings and precautions to be aware of when taking sertraline:

• Patients with an allergy to sertraline or any of its inactive ingredients should not take the medication.
• Pregnant women or those who may become pregnant should discuss the risks and benefits with their healthcare provider, as sertraline may cause problems in newborns.
• Breastfeeding women should also consult their doctor, as sertraline may pass through breast milk.
• Patients with preexisting eye problems that may increase the risk of angle-closure glaucoma may require an eye exam before starting sertraline.
• Individuals with bipolar disorder should not take sertraline without also taking a mood stabilizer, as it may trigger a manic or hypomanic episode.

Suicidal Thoughts and Behaviors

Perhaps the most significant warning with sertraline is the potential for increased suicidal thoughts and behaviors, especially in young adults. All antidepressants, including sertraline, carry a boxed warning (the strongest warning required by the FDA) about this risk. Patients should be closely monitored, especially at the beginning of treatment or when the dosage is changed.

If you or someone you know is experiencing suicidal thoughts, it is crucial to seek immediate medical attention or contact a suicide prevention hotline.

Managing Sertraline Side Effects

To help manage common side effects of sertraline, consider the following strategies:

• Take the medication with food to help reduce nausea.
• Stay hydrated and eat fiber-rich foods to help with diarrhea or constipation.
• Practice good sleep hygiene to address sleep difficulties.
• Chew sugarless gum or suck on hard candies to alleviate dry mouth.
• Avoid driving or operating heavy machinery if you experience dizziness or drowsiness.
• Discuss any changes in sexual function with your healthcare provider.

Remember, it’s important to work closely with your doctor to monitor any side effects and make adjustments to your medication or dosage as needed.

Sertraline side effects and interactions, and how to avoid them

Sertraline, most commonly known by its brand name, Zoloft, is a popular prescription medication used to treat depression, anxiety, post-traumatic stress disorder, social anxiety disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). It belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), meaning it works by increasing the amount of serotonin in the brain. As with many antidepressants, people who take sertraline may experience some adverse effects. Continue reading to learn about sertraline side effects, warnings, and possible drug interactions. 

RELATED: Sertraline details | Zoloft details

Common side effects of sertraline

With any medication, there is always a risk of experiencing potential adverse effects. To know when you’re experiencing side effects, it helps to understand how the drug should make you feel when it’s working correctly. In the case of sertraline, patients can expect to feel improvements in mood, appetite, sleep quality, energy level, and interest in daily life. In other words, an easing of symptoms like depression and anxiety. 

“Sertraline, just as all other SSRIs, increases circulating serotonin levels in the human body, promoting a sense of well-being and allowing persons with depression and anxiety to cope better with their current situation or condition,” says to Raul Perez-Vazquez, MD, a primary care physician of Tenet Florida Physician Services and West Boca Medical Center.

These are the most common sertraline side effects:

• Nausea
• Diarrhea
• Constipation
• Difficulty falling asleep or staying asleep
• Dry mouth
• Heartburn or indigestion
• Loss of appetite
• Weight loss or weight gain
• Dizziness
• Excessive tiredness
• Headache
• Nervousness
• Changes in sex drive
• Erectile dysfunction, including delayed ejaculation
• Excessive sweating

When do Zoloft side effects go away?

Many of the common side effects listed below can go away after a few weeks while the body adjusts.  

“Sertraline itself takes about a month to start working, and many of the mild side effects diminish after your body has adjusted to the medication,” says David Nazarian, MD, a primary care physician at My Concierge MD in Beverly Hills. 

It’s a good idea to track side effects that you experience and keep your healthcare professional updated so your physician can effectively monitor reactions and adjust medication as needed. Most importantly, tell a doctor if side effects are severe, worsening, or do not go away.

Serious side effects of sertraline

There are some less common, but severe side effects of sertraline. The following symptoms require immediate medical attention:

• Abnormal bleeding or bruising
• Agitation
• Confusion
• Fever, sweating, shivering
• Hallucinations
• Hives or rash
• Loss of coordination
• Muscle stiffness or twitching
• Nausea, vomiting, or diarrhea
• Rapid heartbeat
• Seizures
• Swelling
• Suicidal thoughts
• Trouble breathing
• Uncontrollable shaking of a part of the body

Zoloft withdrawal

Although most of the side effects are reversible, you should not stop taking sertraline abruptly. Instead, speak with a healthcare provider before discontinuing this medication to avoid withdrawal symptoms. A doctor can devise a plan to slowly taper the medication.  Withdrawal symptoms include: 

• Irritability/mood swings 
• Nausea
• Dizziness
• Vomiting
• Insomnia
• Nightmares
• Headache
• Paresthesias (prickling, tingling sensation on the skin)

Collectively, these symptoms are called antidepressant discontinuation syndrome, which requires immediate medical assistance. 

Sertraline warnings

Other FDA warnings include restrictions for:

• Patients who are allergic to sertraline or any of its inactive ingredients
• Pregnant women or those who may become pregnant, as sertraline may cause problems in newborns following delivery
• Women who are breastfeeding since sertraline may pass through breast milk
• Those with preexisting eye problems that may make them susceptible to develop angle-closure glaucoma, which can cause severe eye pain or even blindness. An eye test may be required before receiving a sertraline prescription. 
• Those with bipolar disorder. If sertraline is taken without a mood stabilizer, a patient may be at risk for shifting into a manic or hypomanic episode.

Suicidal thoughts

Perhaps the most significant warning to be aware of when taking sertraline is the potential for suicidal thoughts or actions, especially in young adults. All antidepressants, in fact, have a boxed warning (the strongest warning required by the FDA) about antidepressants and suicidal thoughts and behaviors. 

According to the drugmaker Pfizer, a patient may become suicidal, especially at the beginning of treatment and any time that the dose is increased or decreased. Pfizer advises patients to call a healthcare provider right away if you notice new or sudden changes in mood, behavior, or thoughts. Patients and their families should be made aware of this rare but possible effect. Otherwise, all patients should regularly follow up with a doctor and call between appointments if experiencing any of the following symptoms:

• Feeling agitated, restless, angry, or irritable
• An increase in activity or talking more than usual
• New or worsening depression
• New or worsening anxiety or panic attacks
• Trouble sleeping
• Acting on dangerous impulses
• Acting aggressive or violent
• Thoughts about suicide or dying
• Attempts to commit suicide
• Other unusual changes in behavior or mood

Drowsiness

A common side effect of sertraline is sleepiness, which could affect your ability to react quickly or make clear decisions. For this reason, there is a strong warning not to drive, operate heavy machinery, or do other dangerous activities until you know how sertraline affects you. 

Serotonin syndrome

Serotonin syndrome is a life-threatening condition that can be caused by taking sertraline with other medications that increase the production of serotonin in the body. These medications include:

• Monoamine oxidase inhibitors (MAOIs—don’t use Zoloft within 14 days of these medications). 
• Other SSRIs (like Prozac, Paxil, Celexa, Lexapro)
• SNRIs (like Effexor, Cymbalta, Pristiq)
• Triptans (Imitrex, Maxalt, etc)
• Tricyclic antidepressants (such as Elavil or Pamelor)
• Fentanyl
• Lithium
• Tramadol
• Tryptophan 
• Buspirone
• St. John’s Wort
• Fanapt (iloperidone)
• Thorazine (chlorpromazine)

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Symptoms of serotonin syndrome include:

• High fever
• Rapid changes in heart rate or blood pressure
• Uncontrolled muscle spasms
• Confusion
• Headache
• Heavy sweating 
• Diarrhea
• Stiff muscles
• Loss of consciousness (passing out)

Sertraline interactions

Before taking a new prescription drug, you should disclose all medications that you’re currently taking. Over-the-counter, prescription drugs, and even natural remedies like supplements have the potential to cause harmful drug-drug interactions.

Certain antipsychotics

Mixing sertraline with antipsychotics increases your risk of heart conditions, including cardiac arrest. One example is Orap (pimozide), an antipsychotic medication often prescribed to people with Tourette syndrome. Geodon (ziprasidone) and droperidol are other antipsychotics that could interact with sertraline.

Blood thinners

Taking sertraline with blood thinners (aspirin, Plavix, heparin, warfarin) can increase your risk of bleeding, including nosebleeds as well as stomach and intestinal bleeding. 

Non-steroidal anti-inflammatory drugs (NSAIDs)

Combining sertraline with NSAIDs, like ibuprofen or naproxen, can also increase the risk of severe stomach issues, including life-threatening bleeding, and low sodium levels.

Alcohol

You should not drink alcohol while taking sertraline as both affect chemicals in the brain. Alcohol may alter the effectiveness of sertraline and lead to side effects, including sleep problems and excessive drowsiness. 

Additionally, Antabuse (disulfiram), which treats alcoholism, cannot be combined with the liquid form of sertraline because of the alcohol content in liquid sertraline.

How to avoid sertraline side effects

The best way to prevent sertraline side effects is to take the medication exactly as prescribed by a doctor and in alignment with the drug manufacturer’s instructions. 

The starting dose of sertraline is 25 to 50 mg per day, which can be slowly tapered up if necessary. Sertraline dosages can be adjusted by the physician through close monitoring of the patient and your response to the medication. “Always begin sertraline at the lowest dose, and increase slowly, reevaluating symptoms periodically, and using the lowest effective dose,” says Dr. Perez-Vazquez.

Sertraline can be taken with or without food, according to Pfizer. However, if the liquid concentrate form of sertraline is prescribed, it must be diluted with water, ginger ale, lemon or lime soda, lemonade, or orange juice.

There are a few other steps you can take to help minimize sertraline side effects while you’re waiting for your body to adjust to the new medication. “Some small lifestyle modifications can assist with sertraline side effects, like taking the medication at night to prevent lethargy or eating small frequent meals to avoid nausea,” says Dr. Nazarian. “By listening to your body, noticing the side effects, and making appropriate interventions early on, discomfort can be minimized.” 

Another sometimes overlooked step in ensuring the medication acts as it should is to follow manufacturer instructions on how to store the prescription carefully. Regarding sertraline, the bottle should be tightly closed, kept out of the reach of children, and stored at room temperature, 68°F to 77°F (20°C to 25°C).

What They Are and How to Manage Them

Zoloft (sertraline) is a prescription drug used to help treat certain mental health conditions. It can cause side effects that range from mild to serious. Examples include thoughts of suicide, nausea, tremors, and sexual side effects.

Zoloft is used in adults to treat:

• major depressive disorder
• panic disorder
• post-traumatic stress disorder (PTSD)
• premenstrual dysphoric disorder
• social anxiety disorder

Zoloft is also used in adults and some children to treat obsessive-compulsive disorder (OCD).

The active ingredient in Zoloft is sertraline. (An active ingredient is what makes a drug work.) The drug comes as a tablet and an oral solution, both of which you swallow.

Zoloft has several reported side effects, ranging from mild to severe. But not all people who take Zoloft will experience side effects.

Keep reading to learn about the common, mild, and serious side effects this drug can cause. For a general overview of Zoloft, including details about its uses, see this article.

Some people may experience mild to serious side effects during their Zoloft treatment.

Examples of the drug’s commonly reported side effects include:

• diarrhea
• nausea
• tremors
• decreased appetite
• sexual side effects* such as:
  • erectile dysfunction (problems getting or keeping an erection)
  • trouble reaching orgasm
  • decreased sex drive

* To learn more about this side effect, see the “Side effects explained” section below.

These are just a few of the possible side effects Zoloft may cause. But not everyone who takes Zoloft will experience side effects. Keep reading to learn about other potential side effects of this drug.

Most of the possible side effects of Zoloft are mild and will resolve with treatment.

Examples of mild side effects reported in studies include:

• nausea
• diarrhea
• tremors
• decreased appetite
• indigestion (upset stomach)
• dizziness
• excessive sweating
• dry mouth
• trouble sleeping
• sleepiness
• constipation
• vomiting
• sexual side effects* such as:
  • erectile dysfunction (problems getting or keeping an erection)
  • trouble reaching orgasm
  • decreased sex drive*
• mild allergic reaction*

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Zoloft unless your doctor recommends it.

Zoloft may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Serious side effects from Zoloft are rare but possible. If you develop serious side effects while taking this drug, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Examples of serious side effects that have been reported with Zoloft include:

• closed-angle glaucoma
• seizure
• low sodium levels
• long QT syndrome
• manic episodes*
• increased risk of bleeding*
• serotonin syndrome (a high level of the chemical serotonin)*
• risk of suicidal thoughts and behaviors†
• severe allergic reaction*

* To learn more about this side effect, see the “Side effects explained” section below.
† Zoloft has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Zoloft, visit MedWatch.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

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Zoloft is used to help treat obsessive-compulsive disorder (OCD) in children ages 6 years and older. The possible side effects of Zoloft in children are similar to those listed above for adults. Zoloft has a boxed warning for increased risk of suicidal thoughts and behaviors. (See the “Side effects explained” section below for more information.)

Zoloft may cause your child to have a decreased appetite. This could lead to weight loss and may affect their height and weight growth. Talk with your child’s doctor for more information. They’ll likely monitor your child’s growth if your child needs to take Zoloft long-term.

Get answers to some frequently asked questions about Zoloft’s side effects.

How do side effects of Zoloft in women compare with those in men?

Most Zoloft side effects are similar for males* and females.* But Zoloft’s sexual side effects are different for males and females. Males have an increased risk of erectile dysfunction (problems getting or keeping an erection) and delayed ejaculation (needing more than 30 minutes of sexual stimulation to ejaculate) or failure to ejaculate. Females have an increased risk of trouble reaching orgasm. Both males and females who take Zoloft may have a lower sex drive than usual.

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Will I experience certain side effects of Zoloft during the first week of treatment?

You may be more likely to experience certain side effects during your first week of Zoloft treatment. This is because your body is getting used to the drug. Some common early side effects of Zoloft include headache, nausea, fatigue, and constipation.

Also, keep in mind that Zoloft can increase the risk of suicidal thoughts and behaviors, and this risk may be higher during the first few months of treatment. *

This is not a complete list of side effects, and not all people will experience these side effects. Talk with your doctor for more information.

* Zoloft has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Can Zoloft cause long-term side effects?

Most Zoloft side effects resolve when they are treated or when Zoloft is stopped. Talk with your doctor if you experience side effects. They’ll decide if it’s safe for you to keep taking Zoloft or whether another treatment might be better.

Do not stop taking Zoloft without talking with your doctor first. Stopping this drug suddenly may cause side effects such as dizziness, tremor, nausea, sweating, and mood changes. Talk with your doctor about other possible side effects of stopping Zoloft.

How long does it take for side effects of Zoloft to go away?

Most Zoloft side effects should resolve quickly when they are treated or when Zoloft is stopped. Some side effects may resolve on their own as your body adjusts to the medication. Talk with your doctor about any bothersome side effects. They’ll recommend the best treatment for them.

Does Zoloft cause weight gain?

Weight gain is not a reported side effect of Zoloft in studies. Decreased appetite is a common side effect of this drug that may lead to weight loss. But the condition you’re using Zoloft to treat may lead to weight gain. Talk with your doctor if your weight has changed while taking Zoloft.

Learn more about some of the side effects Zoloft may cause.

Risk of suicidal thoughts and behaviors

Zoloft has a boxed warning for the risk of suicidal thoughts and behaviors in children and adults ages 24 years and younger.* A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Though this side effect was rare in studies, the risk is highest in the first few months of Zoloft treatment or after a change in dosage. Due to this risk, your doctor will monitor you closely for suicidal thoughts and behaviors.

* Zoloft is not prescribed for anyone under the age of 6 years.

What might help

Talk with your doctor right away if you feel like your condition is worsening or you have thoughts of hurting yourself. Call 911 or your local emergency number if you are hurt or need help immediately.

Sexual side effects

Zoloft may cause sexual side effects, such as:

• erectile dysfunction (problems getting or keeping an erection)
• trouble reaching orgasm
• decreased sex drive

These were common side effects in the drug’s studies.

What might help

Tell your doctor if you have any changes in sex drive or other problems during sex that are bothersome. They’ll help you determine whether Zoloft is the cause. If it is, they may recommend a different treatment for your condition.

Increased risk of bleeding

You may have an increased risk of bleeding if you take certain other drugs while taking Zoloft. Some of these drugs include:

• warfarin
• aspirin
• nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

Types of bleeding to tell your doctor about include:

• nosebleeds
• bruising easily
• bleeding gums
• vomiting blood
• bloody or dark, tarry stools

What might help

Tell your doctor before starting or stopping any medications. They’ll monitor you closely if you’re prescribed drugs that can interact with Zoloft. And they can recommend a different treatment option if it’s not safe for you to take Zoloft.

Mania

If you have bipolar disorder and take Zoloft, you may have an increased risk of manic episodes. This was rarely reported, but that’s because people with bipolar disorder were usually not included in the drug’s studies.

Symptoms of a manic episode may include:

• racing thoughts
• excessive levels of excitement, activity, or happiness
• reckless or impulsive behavior
• extreme trouble sleeping
• talking faster or more than usual

What might help

Tell your doctor right away if you experience any of the symptoms above. They’ll recommend the right treatment for you and decide whether it’s safe for you to keep taking Zoloft.

Serotonin syndrome

A rare but serious side effect reported in studies of Zoloft is serotonin syndrome. This is a condition caused by a high level of the chemical serotonin in your body. You may have an increased risk of this side effect if you take certain other medications, but it can also happen if you only take Zoloft.

Symptoms of serotonin syndrome include:

• fast heart rate
• flushing (temporary warmth, redness, or deepening of skin color)
• sweating
• nausea
• vomiting
• diarrhea
• hallucinations (hearing or seeing things that aren’t really there)
• agitation (nervousness, annoyance, or anger)

What might help

Tell your doctor right away if you have any of the symptoms listed above. They’ll likely have you stop taking Zoloft and treat your symptoms. They’ll also likely prescribe a different treatment for your condition.

Allergic reaction

Like most drugs, Zoloft can cause an allergic reaction in some people.

Symptoms can be mild to serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

• an antihistamine you swallow, such as Benadryl (diphenhydramine)
• a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Zoloft, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Zoloft, they may have you switch to a different treatment.

Keeping track of side effects

During your Zoloft treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

• what dose of the drug you were taking when you had the side effect
• how soon you had the side effect after starting that dose
• what your symptoms were
• how your symptoms affected your daily activities
• what other medications you were taking
• any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Zoloft affects you. They can then use this information to adjust your treatment plan if needed.

Talk with your doctor about your health history before starting Zoloft. Factors to consider include those described below.

Boxed warning: Risk of suicidal thoughts and behaviors

Zoloft has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA. Children and adults ages 24 years and younger are at risk of suicidal thoughts and behaviors while taking this drug. To learn more, see the “Side effects explained” section above.

Other warnings

Zoloft may not be right for you if you have certain medical conditions. This is known as a drug-condition interaction. Below are conditions and other factors that may affect whether this drug is a good treatment option for you.

Seizure disorder. If you have a seizure disorder, you may have an increased risk of seizures when taking Zoloft. Due to this risk, your doctor will likely not prescribe this drug for you. Ask them about other treatments that might be better options.

Allergic reaction. If you’ve had an allergic reaction to Zoloft or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Bipolar disorder. If you have bipolar disorder and take Zoloft, you may have an increased risk of manic episodes. Due to this risk, your doctor will likely not prescribe this drug for you. Ask about other treatments that might be better options.

Closed-angle glaucoma. If you have closed-angle glaucoma and take Zoloft, you may have an increased risk of your condition worsening. Due to this risk, your doctor will likely not prescribe Zoloft for you. Ask them about other medications that might be better options.

Bleeding problems. Taking Zoloft can increase your risk of bleeding. If you already have a bleeding problem, such as hemophilia, Zoloft may worsen it. This risk is also higher if you take medications to prevent blood clots. Talk with your doctor about any health problems you may have and any drugs you take before starting Zoloft. They may prescribe a treatment other than Zoloft for your condition.

Liver problems. Having liver problems can cause Zoloft to build up in your body, which may increase your risk of side effects. Tell your doctor if you have liver problems before starting this drug. They’ll likely prescribe a lower dosage for you.

Low sodium level. Zoloft can lower your blood sodium level. If your sodium level is already low, taking Zoloft can reduce it further. Your doctor will likely check your sodium level with blood tests during your treatment. If it becomes too low, they’ll likely have you stop taking Zoloft and provide treatment to increase your sodium level.

Heart problems. Although this side effect is rare, Zoloft may cause irregular heart rhythm. This risk is higher if you already have heart problems, such as slow heart rate or heart failure. The risk is also higher if you take other drugs that affect your heart rhythm. It’s important to talk with your doctor about your health history and all the medications you take before starting Zoloft. They’ll let you know if this drug is the right treatment for your condition.

Alcohol and Zoloft

There are no reported interactions between alcohol and Zoloft. Talk with your doctor to see whether it’s safe for you to consume alcohol while taking this drug.

Note that you should not take disulfiram (a drug that helps treat alcohol use disorder) with Zoloft oral solution. This is because there is alcohol in this form of Zoloft, and taking it with disulfiram can cause certain side effects, such as nausea and vomiting. You should seek immediate medical attention if this occurs.

Pregnancy and breastfeeding while taking Zoloft

The risk of taking Zoloft while pregnant may depend on how far along your pregnancy is. Studies show that it may be safe to take Zoloft during the first 3 months of pregnancy. The risk of problems with fetal development (commonly known as birth defects) may be low during this time.

But there are potential risks to the fetus if you take Zoloft during the last 3 months of your pregnancy. Once born, your child may experience:

• feeding problems
• breathing problems
• seizure
• hypoglycemia (low blood sugar)
• shaking
• constant crying

But it’s also important to treat your mental health conditions while pregnant. Talk with your doctor before starting Zoloft if you’re pregnant or trying to become pregnant. They’ll help you decide whether you should take Zoloft during this time.

It’s not known whether it’s safe to take Zoloft while breastfeeding. Small amounts of the drug are known to pass through breast milk. And your child has a risk of side effects if you breastfeed them while you’re taking Zoloft. Talk with your doctor about the best treatment option for your mental health condition if you choose to breastfeed your baby.

The common side effects of Zoloft are usually mild and go away when treated or when you stop taking the drug. Although rare, there are some serious and severe side effects to watch out for. If you have questions about side effects that Zoloft can cause, talk with your doctor.

Examples of questions to help get you started include:

• Do I have a higher risk of side effects than others?
• Do any of the other medications I take increase my risk of side effects from Zoloft?
• Does my risk of side effects depend on the dosage of Zoloft that I take?

To learn more about Zoloft, see these articles:

• Zoloft (sertraline)
• Zoloft Interactions: Alcohol, Medications, and Others

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Treatment and prevention of irritable bowel syndrome

Treatment of irritable bowel syndrome (IBS) depends on the symptoms. Your doctor should develop an individual treatment for you. If you are concerned about loose stools, then the treatment for you will not be the same as the treatment for patients with constipation.

If your doctor says the problem is “in your head” or there is nothing you can do, see another doctor. Many patients successfully get rid of IBS. You need a doctor who can explain IBS and is interested in helping you identify the causes of your symptoms.

Your treatment may be based on the underlying physical or psychological causes of the illness. This may be lifestyle changes, pharmacological or psychological treatment. The right treatment for IBS may be found through trial and error, but it will eventually be found. The following are some aspects of the treatment of irritable bowel syndrome.

Nutrition for Irritable Bowel Syndrome

Certain foods can trigger an flare-up/attack. It is advisable to keep a log of all foods so that you can later calculate which ones led to the disorder. To identify the foods that are causing your symptoms, eat regularly and write down the foods you ate before your symptoms began. Look for patterns. Often the symptoms do not depend on any particular food, but on its amount at a time. A dietitian can be consulted to identify foods that cause symptoms and prescribe a treatment plan. A nutritionist will determine how your body reacts to a particular food. Sometimes intolerance to something (for example, lactose intolerance) is revealed.

For example, caffeine, milk, chocolate, nicotine, alcohol, and an abundance of fatty foods cause symptoms in someone. However, for some people with IBS, these foods do not cause symptoms.

The traditional treatment for IBS, especially constipation, is to eat fiber-rich foods. Fiber reduces the transit time through the large intestine and reduces pressure on it. You need to eat more fresh vegetables and fruits, eat grains and bran. Your doctor may also recommend soluble fiber supplements.

For some patients with IBS, fiber makes symptoms worse because it can be broken down in the colon by bacteria; this will release gas, which will cause bloating. Fiber intake should be discussed with your doctor. You may need to avoid certain types of fiber, particularly gas-producing foods such as cabbage, cauliflower, broccoli, and legumes. But it is not certain that abstaining from certain foods will eliminate the symptoms.

Medications for irritable bowel syndrome

Your doctor may prescribe certain medications to manage your IBS symptoms. Drug therapy recommended by a physician may include:

• Spasmolytic anticholinergics. These drugs reduce intestinal spasms and can relieve pain, bloating, and discomfort associated with IBS. Examples of such drugs are Dicyclomine (Bentyl) and Hyoscyamine (Levsin). Studies show that these drugs are of limited effectiveness and are best taken if symptoms occur after a meal. Side effects include dry mouth/nose/throat, palpitations, constipation, accommodation disorder (blurred vision of objects), and urinary problems.

• Antidiarrheals, such as Loperamide (Imodium). These drugs are quite effective against diarrhea and are used for frequent loose stools or urgency to defecate.

• Laxatives (such as fiber). They are taken if the main symptom is constipation. Laxatives include psyllium (Metamucil), methylcellulose (Citrucel), and calcium polycarbophil (Equalactin).

• Alocetron (Lotronex) is used to treat symptoms such as severe diarrhea or abdominal pain. Alocetron is a blocker of serotonin 5-HT3 receptors and inhibits the action of serotonin in the intestine. Shortly after Lotronex appeared on the market, it was removed from the market, as it was not 100% safe, but then it was put back on the market and now it is an affordable drug. However, due to its potential side effects, Lotronex is only recommended for use in patients with severe symptoms when prescribed by a gastroenterologist, who should provide the patient with proper instructions for use.

• Tricyclic antidepressants such as amitriptyline (Elavil, Endep, Vanatrip), desipramine (Norpramine), and nortriptyline (Pamelor, Aventil) are often used for symptoms such as pain or diarrhea. They are used in smaller doses in IBS than in depression and reduce pain signals between the gut and the brain. These drugs can also help with sleep disturbances and fibromyalgia, the latter often found among the symptoms of IBS.

• Your doctor may also prescribe selective serotonin reuptake inhibitors (SSRIs) to reduce the depression and anxiety associated with IBS in some patients. SSRI drugs include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Your doctor may also recommend other types of antidepressants, such as mirtazapine (Remeron), venlafaxine (Effexor), and duloxetine (Cymbalta).

• Sedatives can help reduce anxiety, which can make IBS symptoms worse. Doctors sometimes prescribe sedatives such as diazepam (Valium), lorazepam (Ativan), and clonazepam (Klonopin) for people with short-term anxiety attacks that worsen IBS symptoms. These drugs should only be taken under medical supervision as they are addictive.

• Lubiprostone (Amitiza) is used to increase intestinal secretion. It is prescribed for the treatment of severe constipation in women over 18 who are not responding to other treatments.

• Antibiotics can also be used to treat IBS, but it is not entirely clear what benefit they bring. Antibiotics can help those with IBS caused by an overgrowth of bacteria in the gut, but antibiotics can be dispensed with at present to eliminate the bacteria.

How to eliminate or minimize the symptoms of IBS

In IBS, the gut is sensitive to irritants. Symptoms can be minimized or eliminated by identifying what causes the bowel to malfunction. Here are some guidelines that might help:

– Eat regularly by the clock, chew your food slowly and thoroughly, avoid fatty foods and too much caffeine.

— Get regular physical activity. This can help relieve symptoms and feelings of anxiety, which can improve bowel function.

– Do not delay or hasten a bowel movement.

– Do not strain during bowel movements, try to relax and take your time.

Because the large intestine becomes very sensitive in IBS, ordinary events such as eating or distension due to gas or bowel contents can trigger symptoms. Following these tips will help you prevent seizures:

Schedule your meals. Eating causes contractions in the large intestine. Usually, within 30 to 60 minutes after eating, there is an urge to defecate. In IBS, the urge may be more frequent, causing cramps or diarrhea.

Eat small meals. The body’s response to food often depends on calories and especially on the amount of fat it contains. Also, large amounts of food can cause cramps and diarrhea in people with IBS. Symptoms are relieved by eating smaller amounts of food, but more often, or just eating small meals. In any case, try to stick to a regular meal schedule.

Change your diet. For some people, a diet of low-fat, high-fiber foods may help. For some, a diet of foods rich in protein and carbohydrates is needed. Fat greatly stimulates the contractions of the large intestine after eating. The use of caffeine in many people, and especially in people with IBS, leads to frequent loose stools. Important – the diet should be made for each individual.

In many cases, eating foods containing fiber can relieve constipation, but not pain. Sources of fiber include cereals, peas, beans, fruits and vegetables, and whole grain breads. Fiber can also be consumed in the form of dietary fiber supplements, which can be found over the counter, but you should consult your doctor before taking.

Some medications (including antibiotics) can trigger IBS attacks in some people. You need to tell your doctor all about your problem so that he can recommend other drugs to treat the symptoms of IBS that will not cause attacks.

Physical, emotional or environmental stress can also cause or worsen symptoms. Stress management and relaxation can reduce or prevent symptoms. Cognitive behavioral therapy, stress prevention, hypnosis, and relaxation can also reduce the symptoms of IBS. Such treatment also reduces anxiety and other psychological symptoms. You can write down what activities trigger your symptoms. Many patients will be better able to control their condition if their IBS symptoms are found to be related to childhood abuse or trauma.

Prevention of irritable bowel syndrome

Irritable bowel syndrome (IBS) is one of those diseases that cannot be “prevented”. This is not a disease that can be avoided by following certain recommendations. However, the symptoms of IBS—chronic crampy abdominal pain, discomfort, bloating, and changes in bowel habits—can be prevented, reduced, and sometimes reversed by addressing its causes.

People with IBS have a more sensitive colon and are very sensitive to both food (even normal gastrointestinal activity) and environmental factors such as stress.

Although doctors don’t know exactly why some people get IBS and some never get it, IBS is a serious functional disorder. Don’t believe if someone tells you that the symptoms are “in your head”.

Lifestyle advice

1. Ask your doctor if you have IBS.

Although over 20 percent of the population suffers from IBS, only 15 percent of people with the condition seek medical attention. If you have severe stomach pain or bowel problems, see your doctor. He will be able to make an accurate diagnosis and begin treatment to relieve symptoms.

2. Keep a journal to identify foods that trigger IBS

People with IBS are encouraged to monitor foods that aggravate the disease. To do this, record the entire diet and note the time of onset or worsening of IBS symptoms. Notes with information about the type and amount of food eaten, as well as the time of eating, should be done for two to four weeks. It is also necessary to record the time of onset of symptoms – disorders, pain, discomfort, etc.

3. Create a personalized diet

You can create a personalized diet to relieve the symptoms of IBS. There is a certain group of foods that exacerbate the symptoms of IBS. These include fatty foods, dairy products, chocolate, alcohol, caffeinated drinks (such as coffee, tea, cola, and energy drinks), sorbitol sweeteners (found in some chewing gums), and gas-producing foods (such as beans and some other vegetables). However, not all people with IBS need to avoid these foods. Many of them also have lactose intolerance, which causes intestinal problems and abdominal pain, which is similar to the symptoms of IBS. For people with lactose intolerance, to improve the condition, it is enough to remove most dairy products from their diet. Women with IBS who suffer from constipation need to drink more water and eat fiber-rich foods. If you decide to see a nutritionist, we recommend that you contact a qualified dietitian who can explain the relationship between food intake and intestinal problems, as well as design a diet for you that minimizes intestinal disturbances.

4. Avoid unnecessary surgery if you have IBS

Be sure to tell your doctor before surgery that you have IBS. According to studies, patients with IBS are more at risk of unnecessary removal of the appendix or gallbladder than others. According to a survey of 90,000 people, hysterectomy and back surgery are also the most common among IBS patients. Studies have found that gallbladder removal is twice as common in people with IBS as in people without the disease. However, studies have shown that operations on the coronary arteries and for gastric and duodenal ulcers occur in almost equal numbers in patients with IBS and in patients without.

5. Stress management therapy can help

Because stress is one of the causes of IBS symptoms, some stress management technologies such as hypnosis and cognitive behavioral therapy can help. They can reduce feelings of anxiety, improve health, elevate mood, and increase the patient’s sense of responsibility associated with treatment. Since the landmark study was published in the London Lancet in 1984, proving the effectiveness of hypnotherapy in the treatment of IBS, there have been many other studies demonstrating the effectiveness of this treatment. However, you need to make sure that the doctor using hypnosis is qualified to do so.

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Sertraline (Zoloft)

Sertraline is an antidepressant , has a sedative effect. Used in the treatment of depression, various types of panic disorders.

Analogues (generics, synonyms)

• Zoloft;
• Misol;
• Serenata;
• Serlift.

Available by prescription, listed in the regular reporting register .
Active ingredient: Sertralinum

Prescription form 107-1/y
Latin prescription:
05
D.t.d. No. 20 in tab.
S.: Inside, 1 tab. 1 per day.

Formulation
Coated tablets, 50 mg and 100 mg.

10 tablets in a blister pack made of PVC/polyvinyl dichloride film and aluminum foil.

2 blister packs with instructions for medical use in the state and Russian languages ​​are put into a cardboard box

Mechanism of action
Selective 5-HT reuptake inhibitor, does not enhance catecholaminergic activity. It shows no affinity for muscarinic, serotonergic, dopaminergic, adrenergic, histaminergic, GABAergic, or benzodiazepine receptors.

Therapeutic indications
treatment of depressive conditions of various origins in patients with mono- and bipolar affective disorders, prevention of relapses of episodes of depression.

Application
Orally, by swallowing, regardless of food intake and drinking plenty of fluids. The dosage is adjusted by the doctor depending on the disease. The initial daily dose is 25 mg. Maximum up to 200 mg/day.

Contraindications
Hypersensitivity. Simultaneously with MAOI, do not start the course. If it is necessary to take MAOIs, start within 7 days after stopping sertraline and wait 14 days between stopping MAOIs and starting sertraline. Simultaneous use with pimozide.

Warnings and Precautions
Mania/hypomania, epilepsy, schizophrenia, history of bleeding disorders, myocardial infarction, children and adolescents < 18 years of age. Obsessive Compulsive Disorder, the elderly, ECT, diabetes, angle-closure glaucoma or a history of glaucoma. Warn about the need to monitor the emergence of suicidal behavior and auto-aggression. Risk of hyponatremia, serotonergic syndrome, or MHC (increased when taken with: other serotonergic drugs such as triptans that disrupt your metabolism, such as methylene blue, antipsychotics and other dopamine antagonists, and opiate drugs; monitor the patient for signs/symptoms). Simultaneous reception with other serotonergic drugs (tryptophan, fenfluramine, serotonin agonists, St. John’s wort). Strict control of switching from other antidepressants or anti-obesity drugs to sertraline. Not recommended for use with grapefruit juice. Caution in patients with risk factors for QT prolongation.

Liver failure
Precaution. Use lower doses or reduce frequency. It should not be used in severely expressed syndrome.

Interactions
Increases the risk of bleeding when taking: ASA and their derivatives, NSAIDs, blood thinners, ticlodipine.
Increased prothrombin time with: warfarin (control).
Decreases clearance with: cimetidine.
Caution with: lithium, fentanyl (under anesthesia or chronic pain).
Risk of prolongation of the QTc interval and / or ventricular arrhythmias when taking other drugs that prolong the QTc interval (certain antipsychotics and antibiotics).
Monitor plasma concentrations of: phenytoin.
Monitoring of the patient simultaneously with: sumatriptan.
SSRIs may reduce plasma cholinesterase activity, resulting in a prolongation of the neuromuscular blocking action of mivacurium or other neuromuscular blocking agents.
Laboratory: false + in urine immunoassays for benzodiazepines.

Pregnancy
Well-controlled studies in pregnant women are not available. However, a significant amount of data did not reveal any signs of congenital malformations caused by sertraline. Animal studies show evidence of reproductive effects, probably due to maternal toxicity caused by the pharmacodynamic action of the compound and/or the direct pharmacodynamic action of the compound on the fetus.
Sertraline use during pregnancy has been reported to cause symptoms consistent with withdrawal reactions in some neonates whose mothers were treated with sertraline. This phenomenon has also been observed with other SSRI antidepressants. Treatment with sertraline during pregnancy is not recommended unless the clinical situation of the mother is such that the expected benefits of treatment outweigh the potential risks.
Neonates should be observed if the mother continues sertraline treatment late in pregnancy, especially in the third trimester. The following symptoms may occur in neonates following maternal sertraline use in late pregnancy: respiratory distress, cyanosis, apnea, convulsions, unstable temperature, feeding problems, vomiting, hypoglycemia, hypertension, hypotension, hyperreflexia, tremor, restlessness, irritability, lethargy, constant crying, drowsiness, and trouble sleeping. These symptoms can be caused by both serotonergic effects and withdrawal symptoms. In most cases, complications begin immediately or soon (<24 hours) after delivery.
The results of epidemiological studies suggest that the use of SSRIs during pregnancy, especially at its late stage, may increase the risk of persistent pulmonary hypertension of the newborn (PPNH).

Breastfeeding
Published data on sertraline levels in breast milk indicate that small amounts of sertraline and its metabolite N-demethylsertraline are excreted in milk. Generally, negligible levels have been found in plasma samples from children, with the exception of one child with a plasma level of about 50% of the mother’s level (but without a noticeable effect on the health of this child). To date, no adverse reactions have been reported in children of breastfed mothers taking sertraline; however, a risk cannot be ruled out. Sertraline is not recommended for use in women who are breastfeeding unless, in the judgment of the physician, the benefits outweigh the risks.

Effects on ability to drive
Sertraline may cause sedation, dizziness.