8 Zoloft Side Effects You Should Know About

The antidepressant is super-common—but it's not for everyone


Ashley Mateo |

Have you ever seen the original Zoloft commercial? The one where a sad little blob rolled around on screen with a rain cloud hovering over its head?

That commercial first debuted back in 2001, and since then Zoloft, or Sertraline hydrochloride, has become one of the top psychiatric drugs used by adults, according to one recent .

“Zoloft is one of the first-line antidepressant medications prescribed for both depression and anxiety, meaning it’s one of the most likely to work,” says Dr. Alison Hermann, a clinical psychiatrist at Weill Cornell Medicine and New York-Presbyterian Hospital.

Zoloft is part of a class of drugs called SSRIs, or selective-serotonin re-uptake inhibitors. “Their main effect has to do with changing the signaling of one of the main neurotransmitters in the brain, serotonin, which modulates mood,” explains Dr. James Murrough, the director of the Mood and Anxiety Disorders Program at the Icahn School of Medicine at Mount Sinai. “These medicines tend to increase the availability of serotonin in the brain, which can help boost your mood.”

And that’s the goal, right?

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In general, antidepressants are well tolerated. But, like with all drugs, there are Zoloft side effects—some of which are merely annoying and some of which can actually be dangerous. “I generally start my patients on the lowest milligram pill and have them cut it in half for the few few doses just to make sure you’re tolerating it before bumping it up,” says Hermann.

So if you’re prescribed Zoloft, here’s what to look out for:

1/ GI Effects

“Interestingly, there’s actually a lot of serotonin in the gastrointestinal tract, so people on Zoloft can experience changes in GI function,” says Murrough. “That could mean an upset stomach, nausea, or changes in bowel habits like constipation or diarrhoea.” Murrough suggests starting on the lowest possible dose to avoid these issues, then increasing the dosage as your system acclimates to the extra serotonin.

2/ Sexual Side Effects

This is one of those side effects no one wants to talk about, but it can affect at least a third of patients on SSRIs, says Murrough. “We don’t know why drugs like Zoloft have sexual side effects, but people can experience things like difficulty orgasming, a lack of sex drive, or the inability to get or maintain an erection.” For some people, the benefits of the medicine will outweigh the negative effects on their sex life; for others, a change in medication may be necessary.

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3/ Increased Anxiety

Another one of the more common Zoloft side effects is called akathisia. “It’s like feeling amped up or restless, like you need to move, or like you’re unable to calm down,” explains Hermann. In some cases, akathisia can even feel like a panic attack. But akathisia can be mitigated by starting on a really low dose and slowly working your way up, she adds.

4/ Mood Or Behaviour Changes

Obviously, you want your mood to change while taking an antidepressant or anti-anxiety drug. “But the mood or behaviour change that we’re most worried about as mental health professionals is increased depression or suicidal thoughts or a switch from depression to mania,” says Hermann. “Any antidepressant intervention has the potential to flip someone who’s vulnerable, who has bipolar disorder rather than depression, into a mania, which is why it’s so important to make sure you have the right diagnosis before starting medication.”

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5/ Night Sweats

“Nighttime sweating is a common side effects of SSRIs, and Zoloft is one of the drugs where it’s more common,” says Hermann. “It’s not dangerous at all, provided that the person is seeing an internist regularly and has had a physical exam and lab work within the year to indicate there’s nothing else responsible for it.” It is uncomfortable, though, so Hermann recommends wearing sweat-wicking materials to bed and keeping your bedroom cool enough at night.

6/ Serotonin Syndrome 

“This is a catch-all term for what happens when there’s too much serotonin in the body,” says Murrough. “It affects your blood pressure, can cause severe GI symptoms, and can even lead to confusion, fevers, and seizures—in extreme cases, it’s life-threatening.” The risk is very low for people who are just taking one medication, but if someone is on several medications that affect serotonin levels, the risk level rises. “Sometimes, people describe this as a bad flu—so on the off chance that happens, call your doctor right away,” says Murrough. “The treatment is to simply stop the medication.”

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7/ Trouble Sleeping

In most cases, antidepressants and anti-anxiety meds help people sleep better. But, occasionally, “people report unusual dreams, restlessness during sleep, or feeling like their sleep is altered in some way,” says Hermann. It’s a potential risk of taking something that affects your brain, says Hermann, and if it’s disruptive enough to your life, your doctor might try you on a different drug.

8/ Changes In Weight Or Appetite 

People taking Zoloft gained nearly 1 kilo over the course of a year, according to one published in the journal JAMA Psychiatry. It’s not the only SSRI linked with weight gain, but if that’s a concern for you, talk to your doctor about your options.

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