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Understanding How Zoloft Works


Updated February 28, 2013

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Sertraline, commonly sold as the brand name Zoloft, is a selective serotonin reuptake inhibitor. SSRIs are known as second generation antidepressants since they are newer than MAOIs (monoamine oxidase inhibitors) and TCAs (tricyclic antidepressants). Although it is most commonly used to treat depression, Zoloft is sometimes prescribed for social phobia and other phobias.

SSRIs work by slowing the reabsorption of serotonin in the brain. Serotonin is a chemical neurotransmitter, which transmits electrical impulses from one neuron to the next. Normally, serotonin is quickly reabsorbed, but an SSRI lets the serotonin remain in the synaptic gap between neurons for a longer period of time. This allows the chemical to send additional impulses to the receiving neuron.

Taking Sertraline

Sertraline is available in a variety of strengths, and is only sold by prescription. Both liquid and tablet forms of the medication are available.

Like all medications in its class, sertraline does not perform optimally until you have taken it consistently for several weeks. You may or may not begin to feel the effects more quickly. Talk to your doctor if you have any concerns.

Drug Interactions

Avoid the liquid formulation if you are on Antabuse, or disulfiram, as it contains alcohol. Wait at least 14 days after your last dose of any MAOI before beginning sertraline treatment.

Sertraline interacts with a wide range of natural remedies. Ask your doctor before taking tryptophan, St. John's wort, or any other herbal or natural formulation. In addition, sertraline interacts with numerous prescription and over-the-counter medications, including NSAID pain relievers, diuretics, stomach medicines, blood thinners and treatments for certain mental illnesses. Provide your doctor with a full list of all over-the-counter, prescription and natural products you use, and do not add anything new without your doctor's approval. Avoid alcohol and sedatives while using sertraline.


Since 2005, all SSRIs have carried "black box" warnings from the FDA regarding a higher risk for suicidal ideation and behavior in children. The FDA expanded its warning in 2007 to include young adults under the age of 25. Although many young people successfully take these common medications, informed consent is important. Discuss the benefits and risks with your child's doctor before making a decision.

Like all medicines, sertraline carries a risk for side effects. Common side effects such as dry mouth, sweating and loss of appetite are typically mild and may subside in a few days or weeks. Let your doctor know right away if you experience more severe side effects such as chest pain, aggression or confusion.

Your risks from sertraline may be higher if you have certain medical conditions, including diabetes, low blood sodium levels, seizures and liver disease. Give your doctor a full medical history of all current and previous illnesses. Also let your doctor know if you have a history of drug abuse. If you are currently breastfeeding or pregnant, or if you plan to become pregnant, discuss the risks and benefits of treatment with your physician.

SSRI Discontinuation Syndrome

All SSRIs, including sertraline, carry a risk for a collection of withdrawal symptoms known as SSRI discontinuation syndrome. Common symptoms include odd electrical sensations known as "brain jolts" or "brain zaps," dizziness and headaches. Although the syndrome is not generally considered dangerous, the symptoms can be distressing.


Mayo Clinic. SSRIs. Retrieved February 27, 2013 from http://www.mayoclinic.com/health/ssris/MH00066

U.S. National Library of Medicine. Sertraline. Retrieved February 27, 2013 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0012108/?report=details

Roy-Byrne MD, Peter. "SSRIs and Suicide Risk: A Concern for Adults, Too?" Journal Watch Psychiatry. March 9, 2005. Retrieved February 27, 2013 from http://psychiatry.jwatch.org/cgi/content/full/2005/309/1

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