Reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Medication is a common treatment for mental or psychiatric disorders, and some medications can treat multiple disorders or conditions. Zoloft® (the brand name of sertraline) is one of those medications. Often the first-line medication for depression, certain anxiety disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and more, a Zoloft dosage may vary depending on which condition you have.
Whether you suffer from a depressive disorder primarily or find your anxiety interfering with your daily life, healthcare providers may prescribe Zoloft differently to best treat your symptoms.
We’ll cover what Zoloft dosage you may be prescribed by healthcare providers for each disorder, as well as when to increase Zoloft dosage. We’ll also cover the basics of depression and anxiety disorders that Zoloft treats.
An antidepressant medication used for various disorders, Zoloft is the brand name for the antidepressant while sertraline is the generic version.
Brand-name and generic drugs go through the same testing process and use the same ingredients, according to the Food and Drug Administration (FDA). The differences between generic sertraline and brand-name Zoloft may be some inactive ingredients, cost and slight but not medically significant differences in how the antidepressant drugs perform.
Zoloft belongs to a class of medications known as selective serotonin reuptake inhibitors (SSRIs or serotonergic antidepressants). Selective serotonin reuptake inhibitors are thought to work by increasing serotonin levels.
Serotonin is a neurotransmitter or chemical that regulates 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.
Now that you know more about Zoloft, we’ll go over the psychiatric disorders a healthcare professional would prescribe this medication — starting with major depression.
Major depressive disorder — also referred to as major depression or depression — is a mood disorder characterized by ongoing patterns of negative feelings. More than just periodically feeling sad, major depression is an empty and anxious feeling that negatively affects your ability to function.
Loss of interest in usual activities
Fatigue or low energy
Difficulty sleeping or oversleeping
Noticeably slower speech or movement
Trouble concentrating or remembering things
Physical pain such as headaches, muscle or joint pain
Reduced sex drive
Weight gain or weight loss
Thoughts of suicide
Although the exact cause of depression is relatively unknown, there are certain risk factors for developing major depression including environmental, biological, genetic and psychological factors. Different types of depression can be caused by different factors.
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 moods (depressive episodes) and high, elevated moods of energized behavior (manic episodes).
While depression is a part of bipolar disorder, taking serotonergic drugs like Zoloft can increase the risk of switching from depression to mania.
The most common treatments for managing depressive symptoms are therapy and antidepressant drugs — with Zoloft being a first-line treatment for 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 in treating major depression.
Although not quite classified as a depressive disorder, premenstrual dysphoric disorder (PMDD) has similarities to depression — including depressive symptoms. Zoloft and other serotonergic drugs are also treatments for 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.
While everyday feelings of worry or anxiety are normal, anxiety disorders are a group of psychiatric disorders representing persistent feelings of anxiety, unease or panic that interfere with daily activities.
Just like major depression, there are different types of anxiety disorders — some of which healthcare providers may prescribe Zoloft for.
Generalized anxiety disorder (GAD) is one of the most common psychiatric disorders, affecting 6.8 million U.S. adults. Generalized anxiety disorder also often occurs at the same time as major depression.
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.
Multiple studies have found certain serotonergic drugs — like sertraline — to be effective in the treatment of anxiety disorders. Sertraline may be prescribed by healthcare providers as an “off-label” medication for anxiety — a use for medication other than one it’s been approved for.
Another anxiety disorder that Zoloft is FDA-approved as a treatment for is social anxiety disorder.
If you struggle with this type of anxiety, you’re not alone — approximately 15 million U.S. adults are affected by this disorder.
Treatment with sertraline (the generic form of Zoloft) was both effective and well-tolerated by patients with social phobia for 20 weeks of treatment on a flexible dosage range between 50mg and the maximum dosage of 200mg a day.
Other symptoms during panic attacks include a pounding heart, sweating, shaking, chest pain or numbness. Our guide on panic disorder covers more information on other possible symptoms.
Similar to depression, the exact cause of panic disorder is unknown although several parts of the brain play an important role in fear and anxiety.
Like many other psychiatric disorders, an untreated panic disorder can negatively affect your life. Fortunately, Zoloft is an FDA-approved effective medication for panic disorder.
A study found that patients who received treatment with sertraline experienced fewer panic attacks for more than a couple months of treatment (10 weeks) compared to placebo-treated patients (those treated with an inactive drug).
Another FDA-approved use of Zoloft, obsessive-compulsive disorder is a common disorder where a person has uncontrollable, recurring behaviors (compulsions) and thoughts (obsessions) that interfere with their daily life.
Those with obsessive-compulsive disorder may have obsessions, compulsions or both symptoms that take up time and interfere with their life.
A long-term disorder, posttraumatic stress disorder develops after someone has been through a shocking or dangerous event and may continue to feel stress or fear long after the event.
Women have a higher risk of developing posttraumatic stress disorder and may experience symptoms differently than men.
Some post-traumatic stress disorder symptoms in women include avoiding anything that triggers a memory of the traumatic event, mood symptoms like dissociating, startling easily, difficulty sleeping and more.
Zoloft is also approved by the FDA to treat post-traumatic stress disorder. A 12-week study comparing treatment with sertraline against a placebo found that the sertraline-treated patients had significant improvements in treating their PTSD symptoms over the placebo-treated patients.
Zoloft is available in different strengths. The Zoloft (sertraline) dosage for anxiety may differ from the Zoloft dosage for depression.
The typical starting Zoloft dosage for depression and most conditions is 50mg per day, although a dose of 25mg per day may be used for children and people with panic disorder, social anxiety disorder and post-traumatic stress disorder.
For treating obsessive-compulsive disorder, however, typically higher doses of serotonergic drugs — like Zoloft — are used to treat symptoms.
Healthcare providers might start with a dose of 50mg per day for eight to 12 weeks, with four to six of those weeks at the highest tolerable dose before the maximum 200mg daily dose.
There are two different ways to take Zoloft for PMDD: 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.
Your healthcare provider may start you on a lower Zoloft dosage and gradually increase the dosage no more than once a week.
Since anxiety disorders can vary in severity, healthcare providers may adjust your Zoloft dosage for anxiety based on your symptoms and how you respond to the medication.
Zoloft can take some time to start having an effect. You may notice improvements in energy, appetite and sleep quality in the first one to two weeks. However, a depressed mood may take longer, around six to eight weeks to start showing improvement.
Zoloft and generic sertraline come in the form of either an oral tablet or a liquid concentrate. Your healthcare provider may recommend you dilute the liquid concentrate in water, ginger ale, orange juice or a lemon or lime soda.
You typically take Zoloft once a day, in the morning or evening, unless you’ve been prescribed Zoloft for PMDD and take your Zoloft dosage during your luteal phase.
Follow the instructions provided by your healthcare provider and use the medication only as directed. Seek medical advice from healthcare providers if your symptoms persist.
Compared to other antidepressant drugs, serotonergic drugs like Zoloft generally have fewer side effects while still being an effective treatment. However, you can still experience mild side effects when taking a Zoloft dosage for depression or anxiety.
Common side effects of Zoloft can include:
Weight gain or weight loss
Sleepiness or drowsiness
Sexual side effects such as decreased libido
Although these mild side effects of Zoloft are typically not dangerous, there are several adverse effects or potentially severe side effects that you should be aware of before using this medication.
Adverse reactions to Zoloft can include eye pain, trouble breathing, swelling, unusual bleeding, seizures, faster than usual heart rate, hallucinations or more. If you experience any of these adverse effects, seek medical advice from healthcare providers immediately.
Certain medications can also cause adverse reactions with Zoloft. These include other antidepressant drugs such as monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs), amphetamines, blood thinners, atomoxetine, buspirone, fentanyl, lithium, irregular heart rate medications, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and more.
You also should not abruptly stop taking Zoloft as you may experience withdrawal symptoms. These can include irritability, vomiting, nightmares, headache or a tingling sensation on the skin.
The risk of serotonin syndrome also increases when taking serotonergic drugs like Zoloft. 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, other antidepressant drugs (like tricyclic antidepressants), 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 taking Zoloft.
When used correctly, Zoloft has the potential to help reduce or eliminate the symptoms of the medical conditions it treats. And like any other medication, following the directions from a healthcare professional is crucial.
That’s why Zoloft dosage is so important: an improper dose may have serious side effects — such as the risk of serotonin syndrome — or cause major issues with the effectiveness of your treatment.
Zoloft may also be just one part of an effective treatment for your mood disorder.
Others may include lifestyle changes or therapy — healthcare providers will likely make recommendations for your individual needs, which may include some or all of the options available for treatment.
You should never change a prescription on your own, but there are things you can do without a healthcare provider’s input to work on your mental health — like reading.
If you’re ready to talk to someone, you can look into scheduling an online psychiatry evaluation today.
Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.
She is also an active member of the American Academy of Nurse Practitioners.
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