ADHD Medication & Treatment

Zoloft

Generic: Sertraline hydrochloride
Zoloft is not an FDA-approved ADHD medication, but rather an SSRI used to treat several conditions — depression, anxiety, and OCD — that commonly co-occur with attention deficit hyperactivity disorder.

By Janice Rodden Medically reviewed by ADDitude’s ADHD Medical Review Panel

What is Zoloft?

Zoloft (Generic Name: sertraline) is a selective serotonin reuptake inhibitor (SSRI) medication. In adults, it is commonly used in ADHD treatment plans to address the following conditions, several of which commonly occur alongside attention deficit hyperactivity disorder (ADHD or ADD):

Major depressive disorder (MDD)
Obsessive compulsive disorder (OCD)
Panic disorder
Post-traumatic stress disorder (PTSD)
Premenstrual dysphoric disorder (PMDD)
Social anxiety disorder

In children and adolescents ages 6-18, Zoloft is used to treat OCD. The safety and effectiveness of Zoloft has not been established to treat any other condition in children and adolescents under age 18.

Physicians may recommend a reduced dose for adults over age 65.

How to Use Zoloft

Before starting or refilling a Zoloft prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Zoloft Dosage

As with all medications, follow your Zoloft prescription instructions exactly. Zoloft is taken orally once daily, either in the morning or evening. It is available in two formulations.

Tablets are available in 25mg, 50mg, and 100mg dosages. They should be swallowed whole with water or other liquids.
The oral solution should be measured with the included dropper and dispensed into water, ginger ale, lemon/lime soda, lemonade or orange juice, stirred, then swallowed entirely. Available in 20mg/mL dosage.

Do not drink alcohol while taking Zoloft.

The optimal dosage varies by the condition treated. If you are over 65 years of age, or have certain health conditions, your doctor may recommend a lower dosage.

Your doctor may incrementally adjust your daily dosage until you experience the best response — that is, until you find the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication. Stopping Zoloft suddenly can create serious symptoms including anxiety, irritability, changes in mood, feelings of restlessness, difficulty sleeping, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, or confusion.

Zoloft Side Effects

The most common side effects of Zoloft are similar to those associated with other SSRIs, like Lexapro.

In adults, possible side effects include: nausea, loss of appetite, diarrhea, indigestion, changes in sleep habits (sleepiness or insomnia), increased sweating, sexual problems, tremor or shaking, feeling fatigued, and agitation.

In children, possible side effects include: agitation, increase in muscle movement, nose bleed, urinating frequently, incontinence, aggression, heavy menstruation, and possible slowed growth rate and weight change. Your physician should monitor your child’s height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

Other serious side effects include increased risk of suicidality or manic episode, abnormal bleeding, seizures or convulsions, changes in appetite or weight, vision problems, and low salt levels in the blood. Patients should be monitored and observed closely for worsening depression, changes in behavior, or suicidality, especially when starting treatment or changing dosage.

Taking Zoloft may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Disclose to your physician all mental health issues including any family history of suicide, bipolar disorder, mania, or depression. The FDA recommends evaluating patients for bipolar disorder prior to the administration of Zoloft to avoid inducing a manic episode. Zoloft may create new or exacerbate existing behavior problems, bipolar disorder, or suicidal ideation, especially in the first few months of treatment or after a dosage change. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including unusual changes in mood, aggressive or violent behavior, or worsening anxiety or depression.

Zoloft increases serotonin levels in the brain, and can rarely lead to life-threatening serotonin syndrome, or toxicity. If you or your child experiences changes in mental status, coordination problems, muscle twitching, racing heartbeat, high or low blood pressure, sweating, vomiting or diarrhea, seek medical help immediately.

Discuss any bleeding disorders or irregular sodium levels with your doctor. Zoloft can cause abnormal bleeding for some patients, and low salt concentration in the blood. The elderly may be at greater risk for these problems.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions Associated with Zoloft

Store Zoloft in a secure place out of the reach of children, and at room temperature. Do not share your Zoloft prescription with anyone, even another person with depression or panic disorder. Sharing prescription medication is illegal, and can cause harm.

You should not take Zoloft if you have an allergy to sertraline or any of the other ingredients in Zoloft.

You should not take Zoloft if you have taken a monoamine oxidase inhibitor (MAOI) within 14 days, or are taking the antipsychotic medication Orap; it can cause a serious, even life-threatening reaction.

You should not take the liquid formulation of Zoloft if you are taking Antabuse (disulfiram) due to the alcohol content.

You should use caution when taking any SSRIs, including Zoloft, and speak with your doctor if you have liver or kidney problems, heart problems, seizures, bipolar disorder, low blood sodium levels, a history of stroke or high blood pressure, or a history of bleeding problems.

If you’re thinking of becoming pregnant, discuss the use of Zoloft with your doctor. It is not known if Zoloft can cause fetal harm during pregnancy. Some Zoloft may pass into breastmilk. Discuss the best way to feed your baby while taking Zoloft with your doctor.

Interactions Associated with Zoloft

Before taking Zoloft, discuss all other active prescription medications with your doctor.

Zoloft can have a dangerous, possibly fatal, interaction with certain antidepressants including MAOIs, and the antipsychotic medication Orap.

The liquid formulation of Zoloft can interact with Antabuse (disulfiram) due to the alcohol content. Taking Zoloft while taking blood thinners like warfarin, ibuprofen, or aspirin can increase the risk of abnormal bleeding. Using Zoloft concurrently with medication that increases serotonin – like St. John’s wort, SSRIs, tryptophan, or street drugs like MDMA – can increase the risk of serotonin syndrome.

Tell your healthcare provider before starting Zoloft if you are taking medication to treat migraines, mood disorders, seizures, pain, heart problems, type II diabetes, or heartburn.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications, you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors and physicians know you are taking Zoloft before having any surgery or laboratory tests.

The above is not a complete list of all possible drug interactions.