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Zoloft for Anxiety: What You Need To Know

Updated at

September 1, 2022

Medically reviewed by

Dr. Siawchwin Lee, FRACGP, BM (Soton)

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Written by

HealthMatch staff

Content
  • Overview
  • What is Zoloft?
  • Does Zoloft help with anxiety?
  • How long does it take for Zoloft to start working for anxiety?
  • How will Zoloft make you feel?
  • Potential side effects
  • Who shouldn’t take Zoloft?
  • Drug interactions
  • When you should see your doctor
  • The lowdown

If your anxiety is starting to have a serious negative impact on your everyday life, you might want to start looking into medication options. 

Zoloft is one anxiety medication that you may have heard of, and it can have impressive effects on mood. 

We’ve gathered together everything you need to know about Zoloft to help you make the best decision for your mental health. 

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What is Zoloft?

Zoloft is a brand of medicine called sertraline used to treat mood disorders. This oral medication belongs to a group of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. 

SSRIs help improve mood by blocking the reabsorption of the hormone and the neurotransmitter serotonin. This allows serotonin to stay in the brain for longer, which is important because serotonin's “happy hormone” has an impressive impact on mood. 

Some of the main benefits of SSRI medications are that they have no dependence potential and better patient tolerability, and a lower risk of lethality in overdose, unlike other psychiatric medications like benzodiazepines. 

You may be prescribed Zoloft by your doctor if therapy options like cognitive behavior therapy aren’t helping to ease your anxiety. 

Does Zoloft help with anxiety?

Aside from its ability to improve the symptoms of depression, studies have shown that Zoloft significantly reduces¹ anxiety symptoms.

Importantly, this research also showed that Zoloft is still an effective treatment for depression and anxiety regardless of any other psychiatric conditions. This means that Zoloft provides clinical benefits² for patients with depressive symptoms in primary care. 

The anxiety-reducing properties of Zoloft

One study³ investigated the effectiveness of Zoloft in the treatment of anxiety disorders in older adults. The study compared the effects of Zoloft to cognitive behavior therapy and a waitlist control group. 

All patients in the study were 60 years of age or older and had a diagnosis of generalized anxiety disorder, panic disorder, agoraphobia, or social phobia. 

The study found that patients who received both Zoloft and cognitive behavior therapy saw a significant improvement in their anxiety, worry, and depressive symptoms immediately after treatment and at a three-month check-up. 

When used with cognitive behavior therapy, Zoloft can generate significant results. 

An option for hard-to-treat anxiety

Zoloft’s anxiety-reducing properties also seem to work for people with hard-to-treat anxiety, like panic disorder. 

Around 50% of⁴ people with a generalized anxiety disorder will not respond to standard treatments, meaning that medication options that help these hard-to-treat conditions are desperately needed. 

One double-blind⁵ study investigated the effects of Zoloft on people with panic disorder, with or without agoraphobia. The study found that Zoloft significantly reduced full and limited-symptom panic attacks. 

Overall, the study concluded that Zoloft effectively treated people with panic disorder. It was also well-tolerated, with only 9% of participants ending treatment due to side effects. 

Zoloft as a treatment for childhood anxiety

Zoloft is not only an effective anxiety treatment option for adults but has also demonstrated an ability to treat childhood anxiety. 

A 2018 study⁶ investigated the effectiveness of both medication and cognitive behavior therapy in treating childhood anxiety disorders. 

Overall, the study found that SSRIs significantly reduced anxiety symptoms in children and, specifically, a combination of Zoloft with cognitive behavior therapy significantly reduced anxiety symptoms.

How long does it take for Zoloft to start working for anxiety?

Psychiatric medications aren’t like pain killers, as they tend to take a few weeks to kick in. 

If you’ve started Zoloft, you can expect to see a reduction in your anxiety symptoms after roughly two to six weeks.

Zoloft doesn’t start working for anxiety immediately after the first dose. It takes a while⁷ for the medication to start to block the process of recycling serotonin out of your system. 

Zoloft and other SSRI antidepressants affect serotonin reuptake more and more over time (until maximum effects are reached). This means that your anxiety symptoms should gradually reduce as you continue to take Zoloft. 

It’s important to remember that Zoloft works gradually and builds up, so you shouldn’t take more than your recommended dose if you’re not experiencing the results you want. 

Talk to your doctor if you feel that your symptoms are not improving after 1–2 weeks. They’ll be able to advise you on the appropriate dosing. 

How Long Do Anxiety Medications Take To Work? Here’s What You Need To Know

How will Zoloft make you feel?

Zoloft can help reduce anxiety, but how will it make you feel? 

Once you’ve been taking Zoloft for long enough to feel its effects, you should start to experience feelings of relief, relaxation, and calm as the weight of your anxiety begins to lift. 

Some other changes that you might notice are an increase in your energy levels and appetite. You may also find that you start to get a better night’s sleep. 

You might also notice an improvement in your motivation levels and overall quality of life. Some people even find that the medication completely fixes their anxiety symptoms. 

It’s important to note that not all people experience Zoloft in the same way. While some may find their anxiety stops, others may only experience some lessening of symptoms. 

Be sure to discuss how the medication is working for you with your doctor so that they can help to tailor your dosing and treatment plan to get you the best results. 

Potential side effects

As with most medications, Zoloft can cause some side effects, though it is largely considered to be well-tolerated. 

However, it’s important to be aware of potential side effects so that you can consult your doctor if they do not settle down after a couple of days. 

Some side effects from Zoloft may include:

  • Nausea

  • Loss of appetite or indigestion

  • Diarrhea

  • Excessive sweating

  • Tiredness or fatigue

  • Sexual performance issues, e.g., reduced sex drive, failure to ejaculate

  • Sleep disturbances, e.g., sleepiness or insomnia

  • Shaking hands

  • Increased agitation and irritability 

There are also some specific side effects that you should look out for in children, including:

  • Nose bleeds

  • Urine problems, e.g., incontinence  

  • Changes to menstruation, specifically heavier periods

  • Agitation or fidgeting

  • Aggressive or irritable behavior that is out of the norm 

  • Changes to physical development, i.e., a child’s growth rate starts to slow down and/or experience slight weight loss.

Some potentially serious side effects⁸ can occur from Zoloft use. 

Serious side effects can include:

  • Suicidal ideations 

  • Impulsive and dangerous behavior

  • Worsening of depression and/or anxiety symptoms

  • Violent behavior

  • Seizures

  • Activation of mania, e.g., fast-paced and racing thoughts, extreme high and low emotions, excessive energy and talking, grandiose thinking 

  • An allergic reaction where typical symptoms include trouble breathing, a rash or hives, and swelling

  • Eye problems, e.g., blurred vision, red eyes, pain in the eyes

  • Serotonin syndrome with symptoms including hallucinations, agitated behavior, loss of consciousness/coma, increased heart rate, vomiting, and rigid muscles

If you experience any of these symptoms, you should contact your doctor or emergency services as soon as possible. We recommend discussing the risk of these side effects with your doctor and putting together an action plan in case they occur. 

Who shouldn’t take Zoloft?

While Zoloft can offer some good anxiety-reducing effects, there are some people for whom the drug may not be a good match. 

Conditions that can impact the effect of Zoloft include:

People with angle-closure glaucoma

People with angle-closure glaucoma conditions can experience an increase in glaucoma attacks if they take Zoloft. Therefore, they should talk to their doctor to determine if the SSRI is appropriate. 

People with seizure conditions

Since seizures are already a potential side effect of Zoloft, the medication should be considered carefully in people with a seizure condition lest it increases their frequency or severity. 

People with liver issues

Patients with liver problems should take care when starting Zoloft as they can experience stronger doses than normal due to their liver’s inability to break down the medication. 

People with bipolar disorder

Bipolar disorder is a possible complication of Zoloft as you can experience a higher risk of manic symptoms.

Drug interactions

It’s also good to be aware of certain medications that do not mix well with Zoloft. There are medications that, when taken alongside Zoloft, can:

  • Increase your risk of serotonin syndrome — monoamine oxidase inhibitors, linezolid, intravenous methylene blue, triptans, lithium, fentanyl, tramadol, and St John’s wort.

  • Cause you to develop heart rhythm problems — pimozide

  • Lead to bruising and bleeding — nonsteroidal anti-inflammatory medications, e.g., aspirin

  • Cause a build-up of medications (including Zoloft) in your system — cimetidine, tricyclic antidepressants

When you should see your doctor

Before starting Zoloft

If your anxiety has got to the point where it is negatively impacting your everyday life, you may want to consider talking to your doctor about whether medication options like Zoloft might be the best treatment choice for you.

Symptoms of anxiety include:

  • Fatigue and inability to sleep 

  • Irritability 

  • Feelings of dread or fear 

  • Hypervigilance and worry 

  • Muscle tensions and jaw clenching/teeth grinding 

  • Inability to focus 

  • Feelings of restlessness 

After starting Zoloft

If your doctor has prescribed you Zoloft, then you consult them should you suffer from any serious side effects that are not resolving. 

It’s also important to talk to your doctor if you don’t feel like Zoloft is effectively reducing your anxiety – they may be able to increase your dosage or recommend a more appropriate treatment option for you. 

The lowdown

Zoloft is an antidepressant medication that has demonstrated an impressive ability to treat anxiety conditions in children and adults. 

Talk to your doctor about the potential benefits and side effects of Zoloft if you’ve noticed that your anxiety may need a little extra help.

Sources

  1. Pharmacotherapy for generalized anxiety disorder in adults and pediatric patients: An evidence-based treatment review (2019)

  2. The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomised trial (2019)

  3. A randomized, controlled trial of the effectiveness of cognitive-behavioral therapy and sertraline versus a waitlist control group for anxiety disorders in older adults (2006)

  4. Management of treatment-resistant generalized anxiety disorder (2020)

  5. Sertraline in the treatment of panic disorder: A double-blind multicenter trial (1998)

  6. Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: A systematic review and meta-analysis (2017)

  7. Sertraline (Zoloft) | National Alliance on Mental Illness

  8. SSRI antidepressant medications: Adverse effects and tolerability (2001)

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