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How to know if your sertraline prescription is working

Woman taking sertraline with water

Antidepressants need time to be fully effective. Here’s what you can expect as you start the medication — and how you might be feeling a few weeks or months later.

Hallie Levine

By Hallie Levine

Sertraline (brand name Zoloft®) is an antidepressant medication. It's used to treat depression and panic attacks.

“It’s a selective serotonin reuptake inhibitor, or SSRI. That’s a fancy way of saying that this medication increases serotonin in the brain. And that leads to improved mood and decreased anxiety,” says Bennett Doughty. He’s a clinical assistant professor at the School of Pharmacy and Pharmaceutical Sciences at Binghamton University in New York.

Serotonin is a neurotransmitter. It sends electrical impulses in the brain from one neuron to the next. This creates a chain of communication. But the communication process isn’t aways a clean one.

“Not all serotonin that’s pushed out makes it to the next neuron,” says Doughty. The body recycles leftover serotonin, sucking it back up. Sertraline shuts off the recycling mechanism. The result? Better overall serotonin communication. And that means a better mood and less anxiety.

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You may not feel a difference right away. But you will notice changes in the coming weeks and months as your body adjusts. Here’s what you can expect as you start taking sertraline.

What conditions is sertraline used for?

Sertraline is an antidepressant. But it’s for more than just depression, says Doughty. It can also treat the following:

  • Depressive disorder
  • Anxiety disorders
  • Eating disorders
  • Post-traumatic stress disorder
  • Some sexual dysfunction conditions

How can you tell if sertraline is working?

It takes about 4 weeks to see changes. But one of the first signs that it’s working is the onset of side effects, says Philip Muskin, MD. He’s a professor of psychiatry at Columbia University Irving Medical Center in New York City.

Some of the first signs are gastrointestinal. You may experience nausea or diarrhea. “The impact on your gut is immediate, which makes sense. Many of your body’s serotonin receptors are found in your gut,” he says. These symptoms should go away in a few weeks.

But within about a month, you should feel a noticeable emotional change. “Your sertraline is working if you feel calmer. Your negative moods or anxiety will not be as intense. You should be enjoying activities more. And your sleeping and eating habits should be more stable,” says Doughty. (Recommended reading: Should you meditate before bed?)

It’s important to check in with your provider every few weeks. This is to make sure you’re taking the right amount of medication. “Since it takes a while to see effects, we don’t like to change the dose every few days,” explains Doughty. You’ll see the full effects within about 12 weeks. 

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Why do you have to start taking sertraline slowly?

Sertraline is generally very well tolerated. But you don’t want to surprise your system. “If you start at a high dose, your body may not be able to process it and side effects may happen,” says Doughty. “That’s why we start low and go slow. Think of easing your way into a pool versus jumping in.” Side effects to watch for include:

  • Sexual dysfunction
  • Drowsiness
  • Weight gain
  • Insomnia
  • Anxiety
  • Dizziness
  • Headache
  • Dry mouth
  • Blurred vision
  • Nausea
  • Rash or itching
  • Constipation
  • Stomach upset

If you experience any of these side effects, talk with your doctor. You may be able to get the same mood-boosting effects at a lower amount. Dividing the amount and taking it during different times of the day may also help. “The good news is that many of these side effects seem to go away by themselves over time,” says Doughty.

What’s the best way to take sertraline?

You can take it as a liquid or a pill. Most doctors suggest that you take it in the morning to lessen insomnia. (Although there’s no evidence that this side effect is related to timing.) It’s also a good idea to take it with food. Food will help your body soak up the medication. And it can prevent stomach upsets.

Is it safe to take sertraline when you’re pregnant?

It is generally considered safe, although there may be some risks. Most studies show that sertraline is not linked to birth defects. There is no evidence that it increases the chances of a miscarriage. There is also no evidence that it causes postpartum hemorrhage. It may slightly raise the risk of an early delivery. But research suggests that it’s only by about 3 days, which is not significant.

What should I do if I think my sertraline isn’t working?

Talk to your doctor. He or she may suggest increasing the amount of medication, says Dr. Muskin. Or your doctor may suggest trying a different antidepressant. You will need to work carefully to wean yourself off sertraline. Don’t stop cold turkey, since that can cause side effects.

“Your body is used to this medication to help it maintain a stable mood,” says Doughty. “It’s like turning off a light and instantly being immersed in darkness. It’s better to slowly dim the light, to let your eyes get used to it. That’s why we slowly decrease the amount of medication.” It’s a process that happens slowly over several weeks.

Sertraline can help you manage the symptoms of depression. Work with your doctor on getting started. Your care team can also help you find other support services, if needed.

No matter how you manage your mental health, we want to help you save on your prescription medication. Simply show this free discount card to your pharmacist — you could save up to 80%.

Additional sources
Sertraline overview: Cleveland Clinic
How to use sertraline — and its side effects: MedlinePlus
Sertraline and pregnancy: National Alliance on Mental Illness