Educational guide
Zoloft interactions: Medications, health conditions, and more
Key takeaways - Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety disorders, PTSD, OCD, and premenstrual dysphoric disorder. It can interact with many medications, including other antidepressants, blood th
This guide cannot diagnose a condition or recommend a personal treatment plan. Discuss medical questions with a qualified professional.
Key takeaways
- Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety disorders, PTSD, OCD, and premenstrual dysphoric disorder. It can interact with many medications, including other antidepressants, blood thinners, and NSAIDs.
- Taking Zoloft with monoamine oxidase inhibitors (MAOIs), other serotonergic medications, or St. John’s Wort can increase the risk of serotonin syndrome, a life-threatening condition. At least 14 days must pass between stopping an MAOI and starting Zoloft.
- Certain health conditions may affect whether Zoloft is safe for you, including bipolar disorder, liver problems, seizure disorders, heart conditions, and bleeding issues. If you have concerns about drug interactions or health conditions, talk with a healthcare professional before starting Zoloft.
Zoloft (sertraline) is an SSRI used to treat the following conditions in adults and children ages 6 years and older:
An interaction occurs when one substance causes another substance to have a different effect than expected. This article explains Zoloft’s interactions and contraindications.
Before you start treatment with Zoloft, tell your doctor and pharmacist which prescription, over-the-counter (OTC), and other medications you take. By sharing this information with them, you may help prevent possible interactions.
If necessary, you may need to take medications that could interact with Zoloft. In this case, your doctor will discuss the risks and benefits of taking these medications together and how to minimize the side effects.
The table below shows medications that can interact with Zoloft.
The following sections explains in more detail how Zoloft interacts with some common medications.
Antidepressants
Zoloft works by affecting serotonin levels. Taking Zoloft with other serotonergic medications can lead to a dangerously high level of serotonin called serotonin syndrome. This life-threatening condition can cause:
- agitation
- hallucinations
- racing heartbeat
- excessive sweating
- muscle twitching
- coma
Drugs that increase this risk include:
- other SSRIs
- SNRIs
- triptans
- tricyclic antidepressants
- fentanyl
- lithium
- tramadol
- buspirone
- amphetamines
Blood thinners and NSAIDs
Medications that interfere with serotonin reuptake, including Zoloft, increase the risk of bleeding events. Taking Zoloft with NSAIDs, such as ibuprofen or naproxen, aspirin, warfarin, or other anticoagulants can further increase your bleeding risk. This can range from bruising to life-threatening hemorrhages.
Your doctor will review any medications you take before prescribing Zoloft.
Certain medication-related factors or conditions could make it dangerous to take Zoloft. These are known as contraindications. They include:
- Taking MAOIs: You should not take Zoloft if you are taking monoamine oxidase inhibitors (MAOIs), such as linezolid or intravenous methylene blue, due to a severe risk of serotonin syndrome. At least 14 days must elapse between stopping an MAOI and starting Zoloft, and vice versa.
- Taking pimozide: Taking Zoloft with pimozide, an antipsychotic prescribed for Tourette syndrome, can increase your risk of irregular heart rhythm.
- Taking disulfiram with Zoloft oral solution: Zoloft oral solution contains 12% alcohol. Taking it with disulfiram is contraindicated because it can trigger a severe disulfiram-alcohol reaction. The oral tablet doesn’t contain alcohol and isn’t known to interact with disulfiram.
- Allergic reaction: Zoloft is contraindicated for anyone who is sensitive to sertraline or any of its other ingredients.
If you’re looking to connect with other people with your condition, resources like Healthline’s Bezzy for Depression offer an online safe space for community, peer and expert guidance, and support.
Zoloft can interact with other substances, such as:
- Alcohol: Because Zoloft oral solution contains alcohol, doctors advise avoiding drinking while taking Zoloft.
- Supplements: The herbal supplement St. John’s Wort interacts with Zoloft significantly, increasing the risk of severe serotonin syndrome.
- Lab tests: Zoloft can cause false-positive results on urine screening tests for benzodiazepines.
Zoloft may not be the right treatment option if you have certain medical conditions:
- Bipolar disorder: If you or anyone in your family has a history of bipolar disorder, tell your doctor. If you take Zoloft for depression, it could trigger a manic or mixed episode.
- Liver problems: Your liver is responsible for breaking down Zoloft in your body. People with mild liver impairment should only take half the recommended dosage. It is not recommended for those with moderate or severe liver impairment.
- Low sodium: Zoloft can cause the sodium levels in your blood to drop dangerously low. Low sodium can lead to headaches, weakness, and confusion. This is a particular risk for older adults and those taking diuretics.
- Eye problems: Zoloft can cause your pupils to dilate, which may trigger acute angle-closure glaucoma in people with untreated narrow eye angles. This is a medical emergency, so getting an eye exam before starting the medication is a good idea.
- Seizures: Doctors aren’t sure how Zoloft affects people with seizure disorders. If you have a history of seizures, your doctor will be cautious about prescribing Zoloft.
- Pregnancy and breastfeeding: Taking Zoloft during the third trimester of pregnancy can lead to lung problems or withdrawal symptoms in a newborn baby. Zoloft also passes into breast milk. Tell your doctor if you’re pregnant, planning to become pregnant, or breastfeeding. Your doctor will discuss the risks and benefits of continuing treatment and together you can decide what is best for you.
- Heart problems: Zoloft can sometimes cause an irregular heartbeat. If you already have a heart condition, your doctor will need to decide if Zoloft is safe for you.
- Bleeding issues: Zoloft can affect how your blood cells clot together, making you bleed or bruise more easily. This can be dangerous if you already have a bleeding disorder, like hemophilia.
- Allergies: If you have ever had an allergic reaction to Zoloft or any of the ingredients in the pill or liquid, you should not take it.
Pregnancy registry
If you are prescribed Zoloft during pregnancy, consider enrolling in the drug’s pregnancy registry. This registry collects information about any pregnancy issues that may be reported with Zoloft. To learn more, talk with your doctor. You can also visit the registry website or call 866-961-2388.
Zoloft (sertraline) is a prescription medication used to treat conditions like depression, anxiety, and PTSD, but it can interact with several other drugs, supplements, and health factors.
Always talk with your doctor about any prescription or OTC medications, supplements, and vitamins you take before starting Zoloft treatment.
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