Zoloft (sertraline) is a prescription drug used to help treat certain mental health conditions. It can cause side effects that range from mild to serious. Examples include thoughts of suicide, nausea, tremors, and sexual side effects.

Zoloft is used in adults to treat:

Zoloft is also used in adults and some children to treat obsessive-compulsive disorder (OCD).

The active ingredient in Zoloft is sertraline. (An active ingredient is what makes a drug work.) The drug comes as a tablet and an oral solution, both of which you swallow.

Zoloft has several reported side effects, ranging from mild to severe. But not all people who take Zoloft will experience side effects.

Keep reading to learn about the common, mild, and serious side effects this drug can cause. For a general overview of Zoloft, including details about its uses, see this article.

Some people may experience mild to serious side effects during their Zoloft treatment.

Examples of the drug’s commonly reported side effects include:

  • diarrhea
  • nausea
  • tremors
  • decreased appetite
  • sexual side effects* such as:
    • trouble reaching orgasm
    • decreased sex drive

* To learn more about this side effect, see the “Side effects explained” section below.

These are just a few of the possible side effects Zoloft may cause. But not everyone who takes Zoloft will experience side effects. Keep reading to learn about other potential side effects of this drug.

Most of the possible side effects of Zoloft are mild and will resolve with treatment.

Examples of mild side effects reported in studies include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Zoloft unless your doctor recommends it.

Zoloft may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Serious side effects from Zoloft are rare but possible. If you develop serious side effects while taking this drug, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Examples of serious side effects that have been reported with Zoloft include:

* To learn more about this side effect, see the “Side effects explained” section below.
† Zoloft has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Zoloft, visit MedWatch.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

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Zoloft is used to help treat obsessive-compulsive disorder (OCD) in children ages 6 years and older. The possible side effects of Zoloft in children are similar to those listed above for adults. Zoloft has a boxed warning for increased risk of suicidal thoughts and behaviors. (See the “Side effects explained” section below for more information.)

Zoloft may cause your child to have a decreased appetite. This could lead to weight loss and may affect their height and weight growth. Talk with your child’s doctor for more information. They’ll likely monitor your child’s growth if your child needs to take Zoloft long-term.

Get answers to some frequently asked questions about Zoloft’s side effects.

How do side effects of Zoloft in women compare with those in men?

Most Zoloft side effects are similar for males* and females.* But Zoloft’s sexual side effects are different for males and females. Males have an increased risk of erectile dysfunction (problems getting or keeping an erection) and delayed ejaculation (needing more than 30 minutes of sexual stimulation to ejaculate) or failure to ejaculate. Females have an increased risk of trouble reaching orgasm. Both males and females who take Zoloft may have a lower sex drive than usual.

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Will I experience certain side effects of Zoloft during the first week of treatment?

You may be more likely to experience certain side effects during your first week of Zoloft treatment. This is because your body is getting used to the drug. Some common early side effects of Zoloft include headache, nausea, fatigue, and constipation.

Also, keep in mind that Zoloft can increase the risk of suicidal thoughts and behaviors, and this risk may be higher during the first few months of treatment.*

This is not a complete list of side effects, and not all people will experience these side effects. Talk with your doctor for more information.

* Zoloft has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Can Zoloft cause long-term side effects?

Most Zoloft side effects resolve when they are treated or when Zoloft is stopped. Talk with your doctor if you experience side effects. They’ll decide if it’s safe for you to keep taking Zoloft or whether another treatment might be better.

Do not stop taking Zoloft without talking with your doctor first. Stopping this drug suddenly may cause side effects such as dizziness, tremor, nausea, sweating, and mood changes. Talk with your doctor about other possible side effects of stopping Zoloft.

How long does it take for side effects of Zoloft to go away?

Most Zoloft side effects should resolve quickly when they are treated or when Zoloft is stopped. Some side effects may resolve on their own as your body adjusts to the medication. Talk with your doctor about any bothersome side effects. They’ll recommend the best treatment for them.

Does Zoloft cause weight gain?

Weight gain is not a reported side effect of Zoloft in studies. Decreased appetite is a common side effect of this drug that may lead to weight loss. But the condition you’re using Zoloft to treat may lead to weight gain. Talk with your doctor if your weight has changed while taking Zoloft.

Learn more about some of the side effects Zoloft may cause.

Risk of suicidal thoughts and behaviors

Zoloft has a boxed warning for the risk of suicidal thoughts and behaviors in children and adults ages 24 years and younger.* A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Though this side effect was rare in studies, the risk is highest in the first few months of Zoloft treatment or after a change in dosage. Due to this risk, your doctor will monitor you closely for suicidal thoughts and behaviors.

* Zoloft is not prescribed for anyone under the age of 6 years.

What might help

Talk with your doctor right away if you feel like your condition is worsening or you have thoughts of hurting yourself. Call 911 or your local emergency number if you are hurt or need help immediately.

Sexual side effects

Zoloft may cause sexual side effects, such as:

  • erectile dysfunction (problems getting or keeping an erection)
  • trouble reaching orgasm
  • decreased sex drive

These were common side effects in the drug’s studies.

What might help

Tell your doctor if you have any changes in sex drive or other problems during sex that are bothersome. They’ll help you determine whether Zoloft is the cause. If it is, they may recommend a different treatment for your condition.

Increased risk of bleeding

You may have an increased risk of bleeding if you take certain other drugs while taking Zoloft. Some of these drugs include:

Types of bleeding to tell your doctor about include:

What might help

Tell your doctor before starting or stopping any medications. They’ll monitor you closely if you’re prescribed drugs that can interact with Zoloft. And they can recommend a different treatment option if it’s not safe for you to take Zoloft.

Mania

If you have bipolar disorder and take Zoloft, you may have an increased risk of manic episodes. This was rarely reported, but that’s because people with bipolar disorder were usually not included in the drug’s studies.

Symptoms of a manic episode may include:

  • racing thoughts
  • excessive levels of excitement, activity, or happiness
  • reckless or impulsive behavior
  • extreme trouble sleeping
  • talking faster or more than usual

What might help

Tell your doctor right away if you experience any of the symptoms above. They’ll recommend the right treatment for you and decide whether it’s safe for you to keep taking Zoloft.

Serotonin syndrome

A rare but serious side effect reported in studies of Zoloft is serotonin syndrome. This is a condition caused by a high level of the chemical serotonin in your body. You may have an increased risk of this side effect if you take certain other medications, but it can also happen if you only take Zoloft.

Symptoms of serotonin syndrome include:

What might help

Tell your doctor right away if you have any of the symptoms listed above. They’ll likely have you stop taking Zoloft and treat your symptoms. They’ll also likely prescribe a different treatment for your condition.

Allergic reaction

Like most drugs, Zoloft can cause an allergic reaction in some people.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you swallow, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Zoloft, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Zoloft, they may have you switch to a different treatment.

Keeping track of side effects

During your Zoloft treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Zoloft affects you. They can then use this information to adjust your treatment plan if needed.

Talk with your doctor about your health history before starting Zoloft. Factors to consider include those described below.

Boxed warning: Risk of suicidal thoughts and behaviors

Zoloft has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA. Children and adults ages 24 years and younger are at risk of suicidal thoughts and behaviors while taking this drug. To learn more, see the “Side effects explained” section above.

Other warnings

Zoloft may not be right for you if you have certain medical conditions. This is known as a drug-condition interaction. Below are conditions and other factors that may affect whether this drug is a good treatment option for you.

Seizure disorder. If you have a seizure disorder, you may have an increased risk of seizures when taking Zoloft. Due to this risk, your doctor will likely not prescribe this drug for you. Ask them about other treatments that might be better options.

Allergic reaction. If you’ve had an allergic reaction to Zoloft or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Bipolar disorder. If you have bipolar disorder and take Zoloft, you may have an increased risk of manic episodes. Due to this risk, your doctor will likely not prescribe this drug for you. Ask about other treatments that might be better options.

Closed-angle glaucoma. If you have closed-angle glaucoma and take Zoloft, you may have an increased risk of your condition worsening. Due to this risk, your doctor will likely not prescribe Zoloft for you. Ask them about other medications that might be better options.

Bleeding problems. Taking Zoloft can increase your risk of bleeding. If you already have a bleeding problem, such as hemophilia, Zoloft may worsen it. This risk is also higher if you take medications to prevent blood clots. Talk with your doctor about any health problems you may have and any drugs you take before starting Zoloft. They may prescribe a treatment other than Zoloft for your condition.

Liver problems. Having liver problems can cause Zoloft to build up in your body, which may increase your risk of side effects. Tell your doctor if you have liver problems before starting this drug. They’ll likely prescribe a lower dosage for you.

Low sodium level. Zoloft can lower your blood sodium level. If your sodium level is already low, taking Zoloft can reduce it further. Your doctor will likely check your sodium level with blood tests during your treatment. If it becomes too low, they’ll likely have you stop taking Zoloft and provide treatment to increase your sodium level.

Heart problems. Although this side effect is rare, Zoloft may cause irregular heart rhythm. This risk is higher if you already have heart problems, such as slow heart rate or heart failure. The risk is also higher if you take other drugs that affect your heart rhythm. It’s important to talk with your doctor about your health history and all the medications you take before starting Zoloft. They’ll let you know if this drug is the right treatment for your condition.

Alcohol and Zoloft

There are no reported interactions between alcohol and Zoloft. Talk with your doctor to see whether it’s safe for you to consume alcohol while taking this drug.

Note that you should not take disulfiram (a drug that helps treat alcohol use disorder) with Zoloft oral solution. This is because there is alcohol in this form of Zoloft, and taking it with disulfiram can cause certain side effects, such as nausea and vomiting. You should seek immediate medical attention if this occurs.

Pregnancy and breastfeeding while taking Zoloft

The risk of taking Zoloft while pregnant may depend on how far along your pregnancy is. Studies show that it may be safe to take Zoloft during the first 3 months of pregnancy. The risk of problems with fetal development (commonly known as birth defects) may be low during this time.

But there are potential risks to the fetus if you take Zoloft during the last 3 months of your pregnancy. Once born, your child may experience:

But it’s also important to treat your mental health conditions while pregnant. Talk with your doctor before starting Zoloft if you’re pregnant or trying to become pregnant. They’ll help you decide whether you should take Zoloft during this time.

It’s not known whether it’s safe to take Zoloft while breastfeeding. Small amounts of the drug are known to pass through breast milk. And your child has a risk of side effects if you breastfeed them while you’re taking Zoloft. Talk with your doctor about the best treatment option for your mental health condition if you choose to breastfeed your baby.

The common side effects of Zoloft are usually mild and go away when treated or when you stop taking the drug. Although rare, there are some serious and severe side effects to watch out for. If you have questions about side effects that Zoloft can cause, talk with your doctor.

Examples of questions to help get you started include:

  • Do I have a higher risk of side effects than others?
  • Do any of the other medications I take increase my risk of side effects from Zoloft?
  • Does my risk of side effects depend on the dosage of Zoloft that I take?

To learn more about Zoloft, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.