Sertraline (Zoloft) for PTSD: Evidence, Dosage, Side Effects & More

Sertraline (Zoloft) For PTSD

Below you will find a practical summary of current evidence and information about taking Sertraline for PTSD.

PTSD stands for post-traumatic stress disorder and is a mental condition that can occur after an individual experiences a traumatic event that causes them to feel shocked, fearful or helpless (e.g. abuse, accidents, war, death of a loved one and more). Effects of PTSD include re-experiencing traumatic events, irritability and anger outbursts, sleep problems, anxiety, avoidance of emotions & thoughts, as well as social withdrawal. PTSD can be either acute or chronic.

Sertraline is the active substance in medications such as Zoloft, and it is classified as selective serotonin reuptake inhibitors (abbreviated as SRI). As the name of the implies, Zoloft works through blocking the reuptake of serotonin in the brains nerve cell synapses, which improves serotonin's effect as a neurotransmitter on the brain. 

This article should not be considered as individual medical advice. Before beginning treatment with Sertraline for PTSD, you should always consult with a healthcare worker, such as a psychiatrist or physician.

Evidence

• Sertraline have been shown in multiple trials to be significantly more effective than placebo in treating PTSD. However, the first-line of treatment for adults with PTSD is typically trauma-focused therapy.

• The overall response rate when using an SSRI, such as Sertraline, for PTSD is approximately 60%. However, only 20-30% of patients achieved full remission, meaning they did not no longer experience any symptoms.

• Compared to placebo, Sertraline improved PTSD symptoms related to irritability and anger outbursts, as well as improving avoidance symptoms (social withdrawal). However, it did not significantly reduce re-experiencing of trauma.

• Taking Sertraline for PTSD was generally well-tolerated, except for increased rates of sleeping problems and gastrointestinal symptoms compared to a placebo.

Treatment with Sertraline for PTSD

• There are two SSRIs that are FDA approved for PTSD, one being Sertraline (Zoloft) and the other one is Paroxetine. 

• Treatment with Zoloft for PTSD is usually started at 25-50 mg a day and increased as needed up to 200 mg a day.

• Recommended treatment duration is at least 6 months.

Side Effects

• Some common side effects of taking Zoloft for PTSD include dizziness, nausea, loss of appetite, dry mouth, diarrhea, difficulty sleeping, and increased sweating.
  
  
• Two side effects that especially may lead to discontinuation of Zoloft are emotional blunting and sexual dysfunction. The latter includes impotency, delayed orgasm, and lowered sexual drive. It is generally advised to lower the dosage or switch antidepressants if these symptoms are not tolerable to the individual. 
  
  
• In rare cases, Zoloft may cause severe side effects such as weight loss, increased risk of bleeding (particularly when taken with other blood-thinning medications), seizures, and serious allergic reactions.
  
  
• Zoloft carries an FDA black box warning due to increased risk of suicidal ideations and behaviors in children, adolescents and young adults taking the medication.

Absolute Contraindications

• Taking or having taken an MAOI drug in the last 14 days.

•  Having moderate-to-severe liver issues.

• Allergy to Sertraline or any SSRI.

Useful Information

• While trauma-focused therapy is the treatment of choice, some individuals with PTSD experience comorbid disorders (e.g. depression, anxiety). Difficulties with motivation or concentration could impede the victim's ability to engage fully in therapy.

• It is possible to avoid the most common side effects of Zoloft by starting with a low dose and gradually increasing it. 

• Many side effects of Zoloft may resolve by themselves within the first few weeks of taking the medication.

Author: J. Martin, M.D. 
Last updated: September 04, 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.