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sertraline
Zoloft
SSRI⚠ Unverified beta content
At a glance
- Class
- Selective serotonin reuptake inhibitor
- Black box
- ⚠ Suicidal thoughts and behaviors
- Key monitoring
- Suicidality / mood / behavior
- Usual adult dose
- Depression / OCD: 50–200 mg/day
- Call provider / escalate if
- Thoughts of suicide or self-harm, or sudden worsening of mood • Agitation, fever, sweating, shivering, muscle twitching/stiffness, diarrhea, fast heartbeat (possible serotonin syndrome) • Unusual bleeding, black/bloody stools
Built-in explanation — generated offline from this app’s structured data (no AI, no network). Still unverified beta content.
What it is
- sertraline (Zoloft) — selective serotonin reuptake inhibitor.
- Used for: Major depressive disorder; Obsessive-compulsive disorder; Panic disorder; PTSD.
Usual adult dosing
- Depression / OCD: 50–200 mg/day (Usual start 25–50 mg once daily; adjust at ≥1-week intervals.)
- Panic disorder / PTSD / social anxiety: 25 mg/day start, then 50–200 mg/day
- Max: 200 mg/day
Boxed warning
- Suicidal thoughts and behaviors: antidepressants increase the risk in children, adolescents and young adults (to age 24) with major depression and other psychiatric disorders. Monitor closely, especially at start and with dose changes.
Monitor
- Suicidality / mood / behavior [Every contact; closely in first weeks & after dose changes]
Nursing priorities
- Baseline mood, suicidal ideation (ask directly), anxiety, sleep, appetite, activity level.
- Screen for history of mania/hypomania or bipolar disorder before/early in treatment.
- Assess suicidal ideation each shift/visit, especially first weeks and after dose changes; follow facility safety protocols.
- Full effect often takes 4–6 weeks; reinforce that early side effects often ease but benefit is delayed.
- Do not stop abruptly; support adherence and report missed doses/side effects.
Major interactions
- MAOIs / linezolid / methylene blue: Serotonin syndrome – contraindicated; allow washout per label (typically 14 days after MAOI).
- Other serotonergic drugs (triptans, tramadol, fentanyl, St John’s wort, other antidepressants, lithium): Increased risk of serotonin syndrome.
Key teaching
- Take it every day, even when you feel better. It can take 4–6 weeks to feel the full effect.
- Do not stop suddenly – talk to your provider first; stopping fast can cause dizziness, “brain zaps,” nausea, and irritability.
- Tell your care team right away about new or worse thoughts of hurting yourself, agitation, or unusual changes in mood or behavior.
Optional: AI explanation
Off by default. To enable, add your own API key in Settings (stored only on this device).
Boxed warning
- Suicidal thoughts and behaviors: antidepressants increase the risk in children, adolescents and young adults (to age 24) with major depression and other psychiatric disorders. Monitor closely, especially at start and with dose changes.
Other serious warnings
- Serotonin syndrome
- Increased bleeding risk
- Hyponatremia / SIADH (older adults, diuretics)
- Activation of mania/hypomania
- Angle-closure glaucoma (rare)
- Seizures (use caution in seizure disorders)
- Discontinuation syndrome with abrupt stop
Sources: FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM C
- Suicidality / mood / behaviorWhen: Every contact; closely in first weeks & after dose changes
- SodiumTarget: Within lab normal range (≈135–145 mEq/L)When: Baseline if at risk; check if confusion, lethargy, falls, nausea
- Bleeding signsBruising, black stools, nosebleeds, especially with NSAIDs/anticoagulants
- Serotonin toxicity signsSee side-effect page
Sources: FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM C
Assessment
- Baseline mood, suicidal ideation (ask directly), anxiety, sleep, appetite, activity level.
- Screen for history of mania/hypomania or bipolar disorder before/early in treatment.
- Medication/supplement list for serotonergic drugs, anticoagulants, NSAIDs.
- Baseline sodium if older adult, on diuretics, or history of hyponatremia.
Interventions
- Assess suicidal ideation each shift/visit, especially first weeks and after dose changes; follow facility safety protocols.
- Full effect often takes 4–6 weeks; reinforce that early side effects often ease but benefit is delayed.
- Do not stop abruptly; support adherence and report missed doses/side effects.
- Monitor for activation (agitation, insomnia, restlessness/akathisia, new mania).
- Give with food if GI upset; may be given AM or PM (AM if insomnia).
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Thoughts of suicide or self-harm, or sudden worsening of mood
- Agitation, fever, sweating, shivering, muscle twitching/stiffness, diarrhea, fast heartbeat (possible serotonin syndrome)
- Unusual bleeding, black/bloody stools
- Confusion, severe headache, weakness, unsteadiness (low sodium)
- Manic symptoms: little need for sleep, racing thoughts, reckless behavior
- Severe rash or eye pain
Sources: FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM C · General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Nausea, diarrhea / loose stools
- Headache
- Insomnia or somnolence
- Sexual dysfunction (decreased libido, delayed ejaculation/anorgasmia)
- Dry mouth, sweating, tremor
- Dizziness
Sources: FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM C
- MAOIs / linezolid / methylene blue MajorSerotonin syndrome – contraindicated; allow washout per label (typically 14 days after MAOI).
- Other serotonergic drugs (triptans, tramadol, fentanyl, St John’s wort, other antidepressants, lithium) MajorIncreased risk of serotonin syndrome.
- NSAIDs, aspirin, anticoagulants, antiplateletsIncreased bleeding risk (GI bleed).
- Diuretics, other hyponatremia-causing drugsAdded risk of hyponatremia/SIADH, especially in older adults.
Sources: FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM C
- Take it every day, even when you feel better. It can take 4–6 weeks to feel the full effect.
- Do not stop suddenly – talk to your provider first; stopping fast can cause dizziness, “brain zaps,” nausea, and irritability.
- Tell your care team right away about new or worse thoughts of hurting yourself, agitation, or unusual changes in mood or behavior.
- Check with a pharmacist/provider before taking other medicines, herbal products (like St John’s wort), or NSAIDs such as ibuprofen.
- Avoid alcohol or limit it; it can make side effects and depression worse.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
Indications
- Major depressive disorder
- Obsessive-compulsive disorder
- Panic disorder
- PTSD
- Social anxiety disorder
- PMDD
Dosing
- Depression / OCD: 50–200 mg/dayUsual start 25–50 mg once daily; adjust at ≥1-week intervals.
- Panic disorder / PTSD / social anxiety: 25 mg/day start, then 50–200 mg/day
- Max: 200 mg/day
Sources: FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM C
Prescriber-oriented details; limited in this beta.
titration
- Start 25–50 mg/day; increase in 25–50 mg steps ≥ weekly to usual range.
hepatic Adjustment
- Use lower or less frequent dosing in hepatic impairment (label: mild – reduce dose; moderate–severe – not recommended).
geriatric
- Monitor sodium; lowest effective dose.
Sources: FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM C
- Verified
- No – unverified beta
- Last reviewed
- 2026-10-29 (drafted; not clinician-reviewed)
- FDA label (DailyMed): ZOLOFT (SERTRALINE HYDROCHLORIDE) TABLET, FILM COATED / SOLUTION, CONCENTRATE [VIATRIS]
- General nursing drug reference conventions (e.g., Davis Drug Guide / Lexicomp nursing) - summarized from standard practice; NOT line-by-line verified