How does Zoloft (Sertraline) work on the brain?

Zoloft is a brand name for Sertraline, a type of antidepressant medication that works on the brain. Zoloft is one of the more common antidepressants prescribed, but how does it work on the brain?

How does zoloft work on the brain? Antidepressants and how they work on the brain is a complex process. Not all antidepressants work in the same way. Treatment for mental health disorders such as depression and anxiety can include zoloft, an antidepressant medication. This works by inhibiting serotonin in the brain. This process does not come without side effects in some people.

Background on Zoloft (Sertraline)

Zoloft is approved for the treatment of various depression disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), social anxiety disorder, obsessive-compulsive disorder and other forms of depression.

Sertraline is the actual medical term for the antidepressant, which can be grouped as an SSRI (Selective Serotonin Reuptake Inhibitor) class of medications. Zoloft is the brand name of Sertraline in the US and also in various countries all around the world.

At the moment, Zoloft is the most widely used antidepressants, especially SSRI antidepressants in the US, with more than 38 million prescriptions in 2017Opens in a new tab.

Here, we will discuss how Zoloft works on your brain as a medication, what conditions it is effective for, and how to use it effectively. We will also discuss some common side effects of Sertraline and its interactions with other medications/conditions.


How Does Zoloft (Sertraline) Work on The Brain?


As a member of SSRIsOpens in a new tab.

Zoloft (Sertraline) has been approved by the FDA in 1991 for the treatment of depressionOpens in a new tab.

Zoloft works by increasing the amount of serotonin in the brain, which will lead to an increase in serotonin concentrations in the synapses. Serotonin is a type of neurotransmitter-a chemical that carries signals between brain cells and nerve cells-, and one of the core functions of serotonin is to regulate mood and producing positive emotions.

Zoloft essentially blocks the reuptake (reabsorption) of serotonin on the brain, allowing more serotonin available. As a result of this, people who take Zoloft often feel improvements in mood, sleep quality, energy level, appetite, and more positive feelings throughout their daily lives. Patients with premature ejaculation have also seen significant improvements in ejaculation intervalOpens in a new tab.

In most people, Zoloft (Sertraline) takes several weeks until they can feel the optimal effects, but the benefits can be noticed almost immediately after starting the medication.

Drug Interactions

Zoloft interacts with various natural remedies for depressionOpens in a new tab.

Zoloft (Sertraline) also interacts with OTC and prescription medications, including stomach medicines, diuretics, and treatments for various mental illnesses. You might want to check out this list for possible drug interactionsOpens in a new tab.

The liquid formulation of Zoloft contains alcohol, so you might want to avoid taking it together with other medications that might interact with alcohol, including disulfiram (Antabuse).

Best Practices in Taking Zoloft (Sertraline)

As with any SSRIs, it is best not to stop taking the prescribed Zoloft even after you’ve felt better. Your doctor/psychiatrist will assess how long you will need to take medicine.

As discussed, Setrtraline might take at least a few weeks before it reaches its full effects, and missing doses may increase the risks for symptoms relapse.

Stopping Zoloft abruptly may result in various withdrawal symptoms including:

  • Irritability
  • Dizziness
  • Nausea/Vomiting
  • Headaches
  • Tingling sensation on the skin
  • Nightmares

Although Sertraline withdrawal is not considered dangerous, the withdrawal symptoms can cause severe discomfort.

If you decide to quit Zoloft, it’s advised to talk to your doctor first so they can help you gradually reduce the dosage.

Zoloft Dosages

Zoloft typically comes in tablet form in various dosage strengths, but commonly it’s available in three different forms: 25mg, 50mg, and 100mg tablets. Zoloft is also available as a liquid formulation (as an oral solution).

The maximum dose for Zoloft is 200mg per day and is typically only used in patients that don’t respond to lower doses. For children, the standard dose is between 25mg to 50mg per day.

Zoloft (Sertraline) Side Effects

You may experience some side effects during the early days of taking Zoloft before you notice you are feeling better from your symptoms, including:

  • Tiredness: is a common side effect of Zoloft (and most SSRIs), especially during the first few weeks of treatment. As your body grows more accustomed to Sertraline, fatigue and tiredness should disappear.
  • Blurred vision: should be mild and should disappear within the first week of taking Zoloft. Contact your doctor otherwise.
  • Headaches: mild headaches during the first weeks are expected, but can be managed by staying hydrated and avoiding alcohol. You can take OTC medication for headaches.
  • Difficulty sleeping: relatively rare, but some people experience difficulty sleeping after using Zoloft (Sertraline). If you take Zoloft only once a day, consider taking it in the morning to help reduce this side effect.
  • Weight gain: a typical side effect for SSRIs. The positive effects of Zoloft might improve your appetite and affect your diet and activity level.
  • Nausea: you can avoid this by taking Zoloft after/with food

There are also severe side effects that might be caused by taking Zoloft:

  • Confusion, extreme anxiety, irritability, or nervousness
  • Allergic reactions like rash, hives, difficulty breathing, and swelling (on the face, mouth, tongue, or throat)
  • Rapid heart rate
  • Seizures and vomiting

These severe side effects are relatively rare, but If you do experience these symptoms, contact your doctor immediately.


All SSRIs, including Zoloft (Sertraline), have carried warnings from the FDA since 2005 regarding an increased risk for suicidal behaviourOpens in a new tab.

Although this is pretty rare and many young people have successfully improved their conditions with Zoloft (Sertraline), it is best to discuss this risk with your doctor before making a decision. If you are deciding for your child, discuss the benefits and risks with your child’s doctor.

Always give your doctor a full medical history of all current and previous illnesses.


Emilie MASI

Registered Nurse, Masters in Advanced Nursing Practice Graduate Diploma of Wound Care Masters of Wound Care

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