Sertraline is a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor). It is often used to treat depression, and also sometimes panic attacks, obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Sertraline helps many people recover from depression, and it has fewer unwanted effects than older antidepressants.
The recommended dose for adults is:
Depression and Obsessive Compulsive Disorder: For depression and OCD, the usual effective dose is 50 mg/day. The daily dose may be increased in 50 mg increments and at intervals of at least one week over a period of weeks. The maximum recommended dose is 200 mg/day.
Panic disorder, Social anxiety disorder and Post Traumatic Stress Disorder: For panic disorder, social anxiety disorder and post traumatic stress disorder, treatment should be started at 25 mg/day, and increased to 50 mg/day after one week. The daily dose then may be increased in 50 mg increments over a period of weeks. The maximum recommended dose is 200 mg/day.
How long will it take sertraline to start working?
- Antidepressants like sertraline can start to work on depression within the first two weeks of treatment, and the improvement continues over the following few weeks. It may take four weeks or longer for you to get the full effect.
- For anxiety, antidepressants like sertraline can take slightly longer to work. For some people, anxiety briefly increases at the start of treatment, but the anxiety does decrease with continued treatment.
- Some side effects of sertraline tend to happen at the start of treatment, but go away after a few days, such as feeling or being sick (nausea or vomiting).
- To get the best effect, you need to take your sertraline every day and give it a chance to work for you.
- Your doctor will start with a low dose that increases slowly to a dose that is effective for you. This may take several days or weeks.
- You will need to take sertraline for several months after you feel better – otherwise your symptoms can come back.
- Keep taking sertraline as you get better, which can take a few months, and then keep taking it. Your doctor will advise you how long as it depends on what you are taking the sertraline for. For depression it might be 6 months, for OCD it might be 12 months and for other conditions such as generalised anxiety disorder it might be up to 18 months.
- If your illness has come back, then you might be advised to keep taking sertraline for longer than this.
- This will help keep you well. If you stop taking the sertraline too soon, there is more chance that your mental health symptoms will come back.
- Discuss with your doctor how long you should take sertraline for.
- If you have bipolar disorder, it is likely that the doctor will advise for the sertraline to be stopped sooner. This is because, in bipolar disorder, there is a risk of your mood becoming too high if an antidepressant is used for too long.
- See your doctor if you want to stop sertraline, to make sure it is not too soon to stop it.
- Also, the sertraline dose will need to be reduced gradually to reduce the chance of side effects when it is stopped (unless you are already on the lowest dose).
Side Effects:
Some side-effects that do appear should get better after a few days. If they do not, you should go back to your doctor. Don’t stop taking Sertraline until you talk to your doctor or you may get withdrawal symptoms as well.
Very common – could affect more than 1 in 10 people:
- Dizziness or headache
- Sleepiness, feeling very tired, or difficulty getting to sleep
- Diarrhoea (loose poo)
- Feeling sick
- Dry mouth
- For men, problems with ejaculation
Common – could affect up to 1 in 10 people:
- Sore throat, teeth grinding, or a funny taste in your mouth.
- Changes in your appetite (feeling more or less hungry)
- Having nightmares
- Feeling anxious, agitated, depressed, nervous, or just strange
- Less interest in sex, or problems having sex – like getting an erection for men
- Numbness and tingling, muscles feel tense, having muscle pain, or shaking
- Problems with your attention
- Effects on your eyesight
- Ringing in your ears
- Palpitations, chest pain, hot flushes and sweating
- Yawning a lot
- Being sick, or having stomach and gut pain
- Having constipation, an upset stomach, lots of wind
- Getting a rash
Withdrawal:
Once you start taking a SSRI, the brain adjusts to having a new level of serotonin around. If you stop taking the SSRI all at once, the balance starts to change again. You could get some symptoms from the change.
Sertraline is not addictive however, you may get uncomfortable withdrawal symptoms if you stop sertraline suddenly, as your body begins to miss it. It is better to agree stopping with a doctor who will reduce you gradually over about 4 weeks.
Some of the withdrawal symptoms include:
- dizziness or headaches
- tingling feelings like pins and needles or numbness
- sleep disturbances (vivid dreams, nightmares, not being able to sleep)
- feeling anxious or agitated
- feeling sick or being sick
- shaking
- These symptoms should stop after 2-3 weeks for most people, but a very few people can get them for 2-3 months or more.
- Most people get mild symptoms, but for a very few people they can be very intense.
- Go and speak to your doctor if you have decided to stop taking your medication.
Your Experiences:
If you take or have taken sertraline in the past please leave a comment describing your experiences so that we can help the rest of the community understand what to expect and help them decide whether this is the right medication for them. 🙂
The Psych Talk 
Until this month, I had taken 200 mg of Sertraline daily for several years. I switched because it seemed like it was no longer helping me. I’m now taking escitalopram. So far, so good
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I was prescribed sertraline after some sort of breakdown to treat depression. I was started on a 50mg dose, after 3 days of pretty heavy side effects I collapsed at home and knocked myself out. I was unconscious for almost 30 minutes. My head was still so fuzzy I stayed on the kitchen floor all night, a visit to my doctor the following day confirmed I had reacted badly to it, and the fact I did not call an ambulance or anyone for help was very dangerous (I couldn’t think let alone move anywhere) the words ‘something like that could kill you’ were left swirling around in my head….this led to problems leaving my house, problems interacting with people, I was then diagnosed with anxiety and off work for months. Sertraline didn’t help me it ruined me. Eventually the doctors went down the old route of amytriptiline. It helps. I only wish they had tried that first.
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Is Sertraline new? Is it expensive? Available in generic? Does it have advantages over Prozac or other SSRIs?
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It is one of the newer forms of antidepressant but has been around in the US since 1991. The price varies depending on country but wholesale price in the US is 1.50USD per month. And it’s hard to say whether it has advantages over other SSRIs as it depends on what is best for an individual. One person may react very badly to sertraline but another might react very well.
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Interesting why this blog decides to highlight Sertraline.
My GPs did trial and error with me when I was 21. I was first put on Citalopram, side-effects made me very numb and dysfunctional, then Lexapro (the GP had free samples in his office) with similar side-effects, then Zoloft (aka sertraline) – also couldn’t function with the side-effects, then Pristiq (an SNRI) and finally, a psychiatrist put me on Mirtazapine (SNRI). Out of those, Mirtazapine was the one I could tolerate the most. Quitting the medication however, was a different kind of torture.
In my opinion, people should exhaust all other options (therapy, social support, etc.) before starting on medication. I was given medication before I even started psychotherapies and if I could go back, I would say no to medication (I would have at least waited until I’m 25-26, when my brain is fully developed).
There is a difference between “situational depression” and “clinical depression”, I believe my depression stemmed from the environment I was in during my adolescent years and difficulties in early adulthood, I only needed help with coping skills and dealing with my situation, perhaps there was nothing wrong with my “chemical balance” and putting me on meds might have actually disrupted the natural development of my brain. And I was “recently” diagnosed with a personality disorder, no drugs could have helped with my personality.
Bottom line is, just be very careful before going on the journey. For some people, it could work wonders because perhaps that is exactly what they need but for others who may be misdiagnosed or half-diagnosed, there are just things you cannot take back.
Doctors wouldn’t give you chemotherapy without running blood test, etc. just because the description of your symptoms sounds like cancer, so why is it okay to give you medication for “chemical imbalance” when they don’t even run tests to see if that’s even the case?
Case in point, I went to the GP and she prescribed a contraceptive pill to deal with my PMS symptoms but when the blood test results came out, it turned out my iron level was 8 ug/L (normal range was 30 – 120 ug/L) and I had low Vitamin D – deficiencies of these two things can also give you depression symptoms. I skipped the contraceptive pill (I’m gay, so I’ve never needed it anyway), got iron infusion and vitamin D supplement instead and my PMS symptoms improved. So there you go, even doctors can prescribe you meds that are not the most relevant to your issues.
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I was on it before; it lasted about 2-3 days before I was taken off due to the side effects. I got really sick and didn’t get back to ‘normal’ until about a month later.
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There should be more caution regarding this medication.
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Horrible drug, makes you overweight and unstable. Be very cautious about taking this medication.
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Is sertraline the same thing as Zoloft??? Why did the original blog post not mention that? I am beginning to wonder about the reliability and quality of information provided by the psych talk blog. The blog does not seem to respond to comments or questions by readers.
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Hello. Yes sertraline is the same as Zoloft. Zoloft is a trade name for the drug. Sertraline is also traded under the name Lustral. I thought it would be better to refer to it by it’s generic/chemical name rather than brand names as those differ from place to place
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Thank you, good explanation. You are right, all these brand names and generic names can indeed be confusing. In the United States, people tend to refer to drugs by their original brand name, even many years after the generic has become available. For example: Prozac, Xanax, Wellbutrin. I can imagine that this sort of thing can be extremely confusing if drugs have different names in many different countries throughout the world. Thanks for your help!
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I’ve been using sertraline for a couple of years now. Before using it, I was highly suicidal, and as the increase in meds continued, the happier I got. Now I’m on 150 mgs of sertraline, and I feel really good. It’s saved my life, and I’m so grateful for that.
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It’s been interesting to read the comments and feel I am not alone regarding taking Sertraline long term.
I have been on the antidepressant for nearly 4 years or so, going from 50mg to 200mg, of which I am currently taking now.
I have done many times what the DRs say not to do, which is stopping taking the medication, whether it be because I have ran out and not ordered another batch in time, or because I had a happy spell and thought I didn’t need it anymore – all occurrences have ended up with me going back to my dark thoughts and suicidal actions.
With this, I cannot express enough how you should not do this! Create alerts in your calendar or do whatever you need to do to not run out!!
I have come across many people who have criticism and general ‘narrow mindedness’ towards antidepressants, however only individuals who have the struggle of mental health and/or depression know what’s best for them, and if taking a tablet or two a day is what we need to help us keep in control, then I don’t see the problem at all
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