Sertraline (Zoloft) For Anxiety: Evidence, Dosage, Side Effects & More

Sertraline For Anxiety

This is a summary of information available about taking Sertraline for generalized anxiety. Sertraline, most famously known as 'Zoloft', is an active substance categorized as a selective serotonin reuptake inhibitor, also known as SSRIs. Sertraline and other SSRIs work by blocking the reuptake of serotonin in the synaptic clefts of the brains nerve cells, which leads to an increased effect of serotonin on the brain. Sertraline is one of the most commonly prescribed antidepressants across the globe.

Provided information is not individual medical advice. Always consult with your physician before starting Sertraline for anxiety. Let your physician know about any concerns you may have or if you're experiencing any side-effects from taking Sertraline. 

Current Evidence

• Sertraline is FDA is not approved in the US for the treatment of generalized anxiety. However, it is frequently used off-label for this indication.

• Multiple studies shows that using Sertraline in anxiety disorders is effective. In addition, the drug is generally well-tolerated. It's effective in treating anxiety and stress disorders, including social anxiety, posttraumatic stress disorder, panic disorders and generalized anxiety disorders.

Treatment with Sertraline for Anxiety

• In adults the initial dosage starts at 25-50 mg once a day. The dose can then be increased by 50 mg per week up to a total of 200 mg once a day if necessary.
  
  
• In children the half-life of Sertraline is significantly lower. Some studies indicate that pre-pubertal children should receive the medicine twice a day instead of once, i.e. taking 12.5 mg twice a day instead of 25 mg once a day. 

• Treatment with Sertraline for anxiety usually lasts for 3 to 6 months.

• It generally takes 4-6 weeks before Sertraline starts decreasing the symptoms of anxiety. In some individuals that take Sertraline the anxiety they experience can worsen in the first couple weeks of treatment before the drug eventually has the wished effect.

Potential Side Effects

• The more commonly occurring side effects when Sertraline for anxiety include dizziness, nausea, loss of appetite, dry mouth, diarrhea, trouble sleeping, increased sweating.
  

• It can cause sexual problems, such as lower sex drive, erectile dysfunction, and trouble with orgasm or ejaculation.

• In recent years there have been research focusing on emotional blunting, a major cause leading to discontinuation of SSRIs. Currently, research suggests it might be dose related, with higher doses being more likely to induce emotional blunting. It is generally advised to lower the dosage or switch antidepressants if this side effect occurs. 

• Severe side effects include weight-loss, increased risk of bleeding, seizures and serious allergic reactions.

• It carries an FDA black box warning due to increased risk of suicidal thoughts and behaviors in children and teenagers.

Absolute Contraindications

• Previous allergic reactions to sertraline or any other SSRI.

• Any history in the last 14 days of taking monoamine oxidase inhibitors (MAOI). 

• Moderate to severe liver problems as it can be liver toxic.

Useful Information

• Side effects that are experienced when starting Sertraline for anxiety commonly dissappears by themselves within the first couple weeks.

• Increasing the dosage slowly lowers the risks of side effects. 

Author: J. Martin, M.D. 
Last updated: August 31, 2024

Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of disease seek immediate medical attention.