Sertraline Dosage Guide

Jill Johnson

Reviewed by Jill Johnson, FNP

Written by Rachel Sacks

Updated 11/23/2022

Sertraline, more commonly known as Zoloft®, is a prescription medication used for several conditions. From anxiety disorders to depressive disorders, bipolar disorder and more, sertraline has a wide range of uses. However, sertraline dosage for each disorder can differ. You may also wonder when to increase sertraline dosage to keep treating a certain condition.

Today, we’re going to give you all the information you need to know about the sertraline dosage range and when you should increase your dosage.

Belonging to a class of medications known as selective serotonin reuptake inhibitors (SSRIs or serotonergic antidepressants), sertraline works to increase serotonin levels.

Serotonin is a neurotransmitter or chemical that helps regulate mood and other functions like energy level, sex drive and mental focus. With normal levels of serotonin, you feel calmer, happier and more focused. Low levels are associated with symptoms of depression and anxiety.

Sertraline is available as either an oral tablet or a liquid concentrate. Both generic sertraline and Zoloft come in different strengths depending if it’s prescribed as a tablet or as an oral solution. Sertraline dosage range can vary depending on the condition you have.

Compared to other antidepressant drugs, serotonergic drugs like sertraline generally have fewer side effects while still being an effective treatment. However, you can still experience potential side effects when taking sertraline.

Common side effects of sertraline can include:

  • Dry mouth

  • Nausea

  • Vomiting

  • Palpitations

  • Decreased appetite

  • Weight gain or weight loss

  • Fatigue

  • Tremor

  • Sleepiness or drowsiness

  • Insomnia

  • Sexual side effects such as decreased libido

  • Agitation

  • Dizziness

Although the most common side effects of sertraline are typically not dangerous, there are several adverse effects or potentially severe side effects that you should be aware of before using sertraline.

These adverse effects can include eye pain, swelling, seizures, unusual bleeding, fast heart rate, trouble breathing, hallucinations, confusion or memory problems. If you experience any of these adverse reactions, seek medical advice from a healthcare provider immediately.

You should also let your healthcare provider know about any other medications you’re taking as there can be drug interactions or adverse effects.

Medications that can cause adverse reactions with sertraline include other antidepressant drugs such as monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs), amphetamines, blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, atomoxetine, buspirone, fentanyl, lithium, irregular heart rate medications and more.

There’s also the potential risk of experiencing withdrawal symptoms if you abruptly stop using sertraline. These can include irritability, vomiting, nightmares, tingling sensation on the skin or headache.

The risk of serotonin syndrome also increases when taking sertraline. Serotonin syndrome is a drug interaction from having too much serotonin in the body. Symptoms of serotonin syndrome can range from mild to severe and even potentially life-threatening.

The risk for serotonin syndrome increases if you take sertraline with other medications or supplements that increase serotonin such as other serotonergic drugs and antidepressant drugs, migraine medications called triptans, St. John’s wort and certain pain medications.

If you experience symptoms of serotonin syndrome, you should seek medical advice from a healthcare professional immediately.

It’s always a good idea to let your healthcare provider know about any other drugs or supplements you currently use before you start treatment with sertraline for any of the following disorders or conditions. 

Your healthcare provider will prescribe a sertraline dosage to best treat your symptoms.

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Sertraline is used to treat several disorders, both approved by the Food and Drug Administration (FDA) and as an off-label treatment.

Below is more information about the different uses and the sertraline dosage range for each use.

Major Depression

Sertraline is a first-line treatment for major depressive disorder — a mental or psychiatric disorder also known as depression or major depression.

A review of studies comparing sertraline to other antidepressant drugs including tricyclic antidepressants and other serotonergic drugs (SSRIs) found that sertraline was more effective than some of the other medications in treating major depression in the acute phase of treatment.

Major depression is a severe mood disorder that negatively affects daily activities such as work, sleeping and eating, and puts you in a low or “empty” mood.

General symptoms of depression are present for at least two weeks and include pessimistic feelings, low energy, trouble sleeping and more.

A depressive episode can also be a part of bipolar disorder, which may be prescribed treatment with sertraline. Bipolar disorder is a psychiatric disorder that includes both low, depressed and indifferent moods (depressive episodes) and high, elevated moods of energized behavior (manic episodes).

While depression is a part of bipolar disorder, taking sertraline can increase the risk of switching from depression to mania.

The usual  starting sertraline dosage for treating major depression is 50mg taken once a day, with the maximum dosage being 200mg per day.

Obsessive-Compulsive Disorder

Sertraline is another FDA-approved treatment for obsessive-compulsive disorder (OCD).

Obsessive-compulsive disorder is a common disorder where a person has uncontrollable, recurring behaviors (compulsions) and thoughts (obsessions) that interfere with their daily life.

Typically higher doses of serotonergic drugs, such as sertraline, are used to treat symptoms of obsessive-compulsive disorder.

A healthcare professional will prescribe a starting dose of 50mg per day for eight to 12 weeks to start, and with four to six of those weeks at the highest tolerable dose before the maximum 200mg daily dose.

Panic Disorders

Panic disorders are a type of anxiety disorder where someone experiences unexpected, frequent panic attacks (a sudden sense of fear with no obvious danger).

Other symptoms during panic attacks include a pounding heart, sweating, shaking, chest pain or numbness. Our guide on panic disorders covers more information on symptoms.

Sertraline is an FDA-approved effective medication for panic disorders.

Multiple short and long-term studies found that an effective and well-tolerated sertraline dosage range for panic disorders is 50mg to 175mg per day.

Another study comparing sertraline-treated patients with 50mg to 200mg daily doses with placebo-treated patients (those treated with an inactive drug) found that the sertraline-treated patients experienced fewer panic attacks over 10 weeks.

The FDA recommends a starting sertraline dosage of 25mg per day, however.

Post-Traumatic Stress Disorder

A disorder that develops after someone has been through a shocking or dangerous event, posttraumatic stress disorder is a chronic disorder.

Women have a higher risk of developing post-traumatic stress disorder and may experience symptoms differently than men. You can learn about posttraumatic stress disorder symptoms in women in our guide.

One treatment option for post-traumatic stress disorder is sertraline, typically starting at a daily dose of 25mg a day, with a maximum dosage of 200mg per day, according to the FDA.

A 12-week study comparing flexible doses of sertraline (between 50mg to 200mg a day) with a placebo found that the sertraline-treated patients had significant improvements in treating their PTSD symptoms over the placebo-treated patients.

Generalized Anxiety Disorder

If you struggle with persistent feelings of worry or anxiety, you may have generalized anxiety disorder (GAD). You may worry about your health, work or daily life in a way that goes beyond typical anxiety and negatively affects your life.

Sertraline may be prescribed by your healthcare provider as an “off-label” medication for anxiety. The average starting dose for sertraline is 50mg a day but your healthcare provider may adjust this based on your symptoms and the severity of your anxiety.

You may also want to know how effective sertraline can be for generalized anxiety disorder.

Multiple studies have found certain serotonergic drugs — like sertraline — to be effective in the treatment of anxiety disorders.

One 12-week study found that patients with generalized anxiety disorder taking a range of sertraline dosages between 50mg and 150mg per day showed greater improvement after four weeks than those taking a placebo.

Another study on 52 elderly patients (60 years and older) found that while the combination of sertraline and cognitive-behavioral therapy (CBT) was most effective for anxiety, worry and depressive symptoms, the medication alone showed the most improvement in worry symptoms.

Social Anxiety Disorder

Another type of anxiety disorder, social anxiety disorder (also known as social phobia) can cause intense fear or anxiety of being judged or viewed negatively in social settings.

If you struggle with this type of anxiety, you’re not alone — approximately 15 million U.S. adults are affected by this disorder.

Fortunately, there are treatment options for social anxiety disorder — such as sertraline, an FDA-approved medication.

Sertraline was both effective and well-tolerated by patients with social phobia in a 2001 study for 20 weeks of treatment on a flexible sertraline dosage range between 50mg and the maximum dosage of 200mg a day.

A healthcare provider may start you with the recommended sertraline dosage of 25mg a day. However, the sertraline dosage range is between 25mg and 50mg daily.

Premenstrual Dysphoric Disorder

Sertraline has also been approved by the FDA for the treatment of premenstrual dysphoric disorder (PMDD).

Premenstrual dysphoric disorder is a condition of severe symptoms that occur before and during your period. PMDD can be similar to premenstrual syndrome (PMS) but involves more serious and debilitating mood disorder symptoms.

Sertraline has been found effective at treating PMDD taken two ways: either as a daily dose ranging between 50mg to 150mg per day, or taken before your period starts during the luteal phase in a dosage range of 50mg to 100mg per day.

You may also want to know when to increase sertraline dosage. This can depend on how you respond to the medication.

When treating major depression, for example, your healthcare provider may increase your dosage by if your symptoms don’t improve after a few weeks. With obsessive-compulsive disorder, however, a higher-than-usual dosage is typically recommended so the sertraline dosage may be increased until the maximum dosage is reached.

It’s common for your sertraline dosage to be adjusted upwards over time in response to your symptoms. The maximum dosage of sertraline is 200mg per day.

Whether you increase or decrease your sertraline dosage, you shouldn’t do so until consulting with your healthcare provider first.

If you’re prescribed sertraline to treat any condition, closely follow the dosage instructions provided by your healthcare provider and use the medication only as directed. Seek medical advice from your healthcare provider if your symptoms persist.

Let your healthcare provider know about any side effects you’re experiencing while taking sertraline as well as any persisting symptoms of your condition so they may work with you to figure out the best sertraline dosage.

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Sertraline is a very common antidepressant medication used in the treatment of several mental disorders, from major depression and anxiety and generalized anxiety disorder, to obsessive-compulsive disorder, premenstrual dysphoric disorder and others.

And while all sertraline is created equal (thanks, FDA regulation!), sertraline dosage is another story. 

Your healthcare provider will prescribe you different dosages of the medication based on several different factors, including your individual needs and the disorder for which the medication is being used to treat.

That said, if you struggle with any of the above disorders or are curious if sertraline would be the best treatment option for you, consult with your healthcare provider.

You can also learn the answers to common questions about sertraline in our guide.

You can also get started on a consultation with our online mental health resources to discuss your symptoms and current health conditions as well as explore other treatment options.

26 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Jill Johnson, FNP

Dr. Jill Johnson is a board-certified Family Nurse Practitioner and board-certified in Aesthetic Medicine. She has clinical and leadership experience in emergency services, Family Practice, and Aesthetics.

Jill graduated with honors from Frontier Nursing University School of Midwifery and Family Practice, where she received a Master of Science in Nursing with a specialty in Family Nursing. She completed her doctoral degree at Case Western Reserve University

She is a member of Sigma Theta Tau Honor Society, the American Academy of Nurse Practitioners, the Emergency Nurses Association, and the Air & Surface Transport Nurses Association.

Jill is a national speaker on various topics involving critical care, emergency and air medical topics. She has authored and reviewed for numerous publications. You can find Jill on Linkedin for more information.

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