Disclaimer: This article is for informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.
Overview
Sertraline is a prescription antidepressant from the selective serotonin reuptake inhibitor (SSRI) group. In Canada it is authorized for adults with depression, panic disorder (with or without agoraphobia) and obsessive-compulsive disorder (OCD). Zoloft is the original brand, and generic sertraline capsules are sold in 25 mg, 50 mg and 100 mg strengths.
Sertraline is usually one part of a treatment plan that may also include talk therapy and regular follow-up. It is not authorized for children and teens under 18 in Canada. Benefits build up over several weeks, and the prescriber regularly reviews whether it is still needed.
If you are struggling with low mood, anxiety or panic attacks, BC residents can speak with a BC-licensed doctor by phone through Avee Health about their symptoms and treatment options. If you are thinking about harming yourself, call or text 9-8-8 or go to the nearest emergency department.
In Canada, sertraline is authorized for adults for the relief of symptoms of:
- Depression
- Panic disorder, with or without agoraphobia
- Obsessive-compulsive disorder (OCD)
Health Canada has not authorized sertraline for anyone under 18. For long-term use in panic disorder and OCD (more than 12 weeks), the prescriber should regularly review whether it is still helping.
Sertraline
Antidepressant (selective serotonin reuptake inhibitor, SSRI)
mental health
Prescription required
Available
How Sertraline Works
Sertraline belongs to the selective serotonin reuptake inhibitor (SSRI) group of antidepressants. It blocks nerve cells from taking back serotonin, a chemical messenger in the brain, which raises the amount available. This is thought to relieve the symptoms of depression, panic disorder and OCD.
It has only very weak effects on other brain messengers. Food increases how much is absorbed by about 40%, which is why it is taken with a meal. Its half-life is about 26 hours, so it is taken once a day, and steady levels are reached after about a week.
Dosage Instructions of Sertraline
Take sertraline exactly as your prescriber directs. The Canadian Zoloft product monograph gives these usual adult doses:
- Depression and OCD: start at 50 mg once a day
- Panic disorder: start at 25 mg once a day, usually raised to 50 mg after 1 week
- If needed, the prescriber may raise the dose gradually, at least 1 week apart, to a maximum of 200 mg a day
Take it once a day with food, ideally with the evening meal, or with breakfast if you prefer mornings. The full benefit can take 4 weeks or longer, and raising the dose faster does not usually speed this up.
Do not stop suddenly. Stopping abruptly can cause dizziness, electric-shock sensations, anxiety, nausea, headache and other symptoms. When it is time to stop, your prescriber will lower the dose gradually over several weeks.
If you miss a dose, ask your pharmacist what to do. Do not change your dose without talking to your prescriber.
Storage Instructions
Store at room temperature, 15°C to 30°C. Keep out of the reach and sight of children.
Side Effects of Sertraline
Side effects are often strongest in the first weeks. In placebo-controlled depression trials in adults, compared with placebo:
- Nausea: 26.1%, compared with 11.8%
- Diarrhea or loose stools: 17.7%, compared with 9.3%
- Trouble sleeping: 16.4%, compared with 8.8%
- Dry mouth: 16.3%, compared with 9.3%
- Sexual side effects in men: 15.5%, compared with 2.2%
- Sleepiness: 13.4%, compared with 5.9%
- Dizziness: 11.7%, compared with 6.7%
- Tremor: 10.7%, compared with 2.7%
Increased sweating, indigestion, agitation, and decreased sex drive in women can also occur.
Get medical help right away if you have:
- Thoughts of harming yourself or others, or new or worse agitation, restlessness, hostility or impulsivity
- Fever, sweating, shivering, muscle twitching or stiffness, a fast heartbeat and confusion, which can be serotonin toxicity
- A fast, pounding or irregular heartbeat, fainting or a seizure
- Unusual bleeding or bruising, or black or bloody stools
- Sudden eye pain, blurred vision, or redness or swelling around the eye
- Headache, confusion, weakness and unsteadiness, which can be signs of low blood sodium, especially in older adults
- Very high energy, racing thoughts and little need for sleep (mania)
Important Safety Information About Sertraline
- Mood and behaviour: antidepressants can increase the risk of suicidal thoughts and actions, and of agitation-type changes, especially in the first weeks or after a dose change and in young adults. Family and friends can help by watching for changes.
- Heart: sertraline can prolong the QT interval. Tell your prescriber about heart disease, a slow or irregular heartbeat, a family history of sudden death under 50, or low potassium or magnesium.
- Bleeding: SSRIs can raise the risk of bleeding, including stomach bleeding, especially with NSAIDs, ASA or blood thinners.
- Other conditions: tell your prescriber about seizures, bipolar disorder or past mania, liver disease, diabetes, glaucoma, osteoporosis or a bleeding disorder.
- Pregnancy: take it during pregnancy only after discussing the risks with your prescriber. Use late in pregnancy can cause breathing and feeding problems in newborns and may raise the risk of heavy bleeding after birth. Tell your prescriber right away if you become pregnant. Talk to them before breastfeeding.
- Falls and driving: sertraline can cause sleepiness or dizziness. See how it affects you before driving, and take extra care if you are older or take sedatives.
Drug Interactions
Tell your prescriber and pharmacist about everything you take, including vitamins, natural products and street drugs. Important interactions include:
- MAO inhibitors (such as phenelzine, tranylcypromine, moclobemide, selegiline, linezolid or methylene blue): must not be taken with sertraline or within 14 days of each other
- Pimozide: must not be taken with sertraline
- Other medicines that raise serotonin, such as other antidepressants, triptans for migraine, tramadol and other opioids, lithium, dextromethorphan, amphetamines and St. John's wort: higher risk of serotonin toxicity
- ASA, ibuprofen, naproxen and other NSAIDs, warfarin and other blood thinners: higher risk of bleeding
- Medicines that affect heart rhythm or blood salt levels, including some antiarrhythmics, antipsychotics, antibiotics and diuretics: higher risk of heart rhythm problems
- Insulin and diabetes medicines, phenytoin and cimetidine: may need closer monitoring
- Urine drug screens: sertraline can cause false-positive results for benzodiazepines
Brands & DIN Number of Sertraline
Brand Names
Zoloft
Key Takeaways
- 1Sertraline (Zoloft) is a prescription SSRI antidepressant for depression, panic disorder and obsessive-compulsive disorder (OCD) in adults.
- 2It is taken once a day with food. The full benefit can take 4 weeks or longer.
- 3Common side effects include nausea, diarrhea, trouble sleeping, sleepiness, dry mouth, tremor and sexual side effects.
- 4In the first weeks or after a dose change, some people feel more agitated or have thoughts of self-harm. Tell your prescriber right away.
- 5Do not stop it suddenly. Your prescriber will taper the dose over several weeks.
- 6It must not be combined with MAO inhibitors or pimozide, and some other medicines raise the risk of serotonin toxicity or bleeding.
Frequently Asked Questions
Do I need a prescription for sertraline in Canada, and how do I get it in BC?
How long does sertraline take to work?
Does sertraline cause sexual side effects?
Can I drink alcohol while taking sertraline?
Can I stop sertraline suddenly?
What is the difference between sertraline and escitalopram?
How much does sertraline cost in Canada?
When should I talk to a doctor about depression or anxiety?
Avee Editorial
Avee Editorial Team