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

Sertraline For OCD

This is a summary of information available for taking Sertraline for OCD. OCD is short for Obsessive Compulsive Disorder, a common mental health condition where an person experiences obsessive thoughts and compulsive behaviors. 

Sertraline, most commonly known under the brand name 'Zoloft', belongs to the group of medications called SSRIs. Sertraline works by interrupting the reuptake of serotonin in the nerve cell endings which leads to an increased effect of serotonin on the brain.

Provided information is not to be interpreted as individual medical advice. Remember to always consult with a psychiatrist before starting Sertraline for OCD or if you have questions related to your health. 

Current Evidence

• Sertraline is one of the four SSRIs that are FDA approved for the treatment of Obsessive Compulsive Disorder, the others being Fluoxetine, Fluvoxamine and Paroxetine. 

• There is convincing evidence that extended pharmacological therapy with Sertraline for OCD is both efficient and safe - both among adults and children.

Treatment with Sertraline for OCD

• There are clear differences in the treatment scheme when taking Sertraline for OCD compared to using Sertraline for anxiety or depressive disorder. 

• The main differences is that Sertraline is commonly prescribed at a maximal daily dose of 200 mg, or in rare cases even up to 400 mg. This is a s opposed to depression, where the rule of thumb is "start low and go slow".

• It can take a minimum of 3-4 months before the treatment has any effect, therefore there must be both practitioner and patient must be patient before deciding if the medicine is effective or not. 

• Using Sertraline as a treatment for OCD in teenagers and preteen children has shown to be effective as well. Improvement was seen with continued long-term treatment.

•  Pediatric dosages range between 50-200 mg for children daily in 6-12 years old children. Sertraline usually taken once a day, but due to lower half-life in children under 12 it may be taken as half the daily dosage twice a day.

Sertraline Side Effects

• The common side effects when taking Sertraline for OCD include loss of appetite, nausea, dizziness, dry mouth, diarrhea, abdominal discomfort, insomnia and increased sweating. 

• It may also cause sexual dysfunction, including decreased libido, erectile dysfunction and difficulties ejaculation or achieving orgasm.

• Among severe side effects it can cause weight loss, bleeding (especially when taken with other blood-thinning medications), allergic reactions or seizures.

• Sertraline has a FDA black box warning due to risk of suicidal thoughts and behaviors in children, adolescents and young adults.

Absolute Contraindications

• Known allergies to any serotonin reuptake inhibitor (including Sertraline).

• Taking or having taken an MAOI drug in the last 2 weeks.

• Moderate to severe liver problems

Useful Information

• Choosing the most appropriate SSRI for OCD is commonly based on the side effects profile, meaning how well it's tolerated by the person taking it. There are no clear proven differences in treatment effect between the four FDA approved SSRIs.

• The maximum adult dose of Sertraline set by the FDA is 200 mg per day, but this was chosen with depression disorder in mind, and not OCD. A psychiatrist might prescribe a higher than maximal dose when choosing Sertraline for OCD.

Author: J. Martin, M.D. 
Last updated: August 22, 2023

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.