Is Zoloft for OCD worth it? What you need to know.

Zoloft (sertraline) is a commonly prescribed selective serotonin reuptake inhibitor (SSRI) for mental health conditions, including obsessive-compulsive disorder (OCD). If you’re curious about Zoloft for OCD, in this article, we give you the information you need to talk to your healthcare provider about whether it’s right for your OCD treatment.

What is Zoloft?

Zoloft (sertraline) is made by Pfizer and was approved by the U.S. Food and Drug Administration (FDA) to treat depression in 1991. It was approved to treat OCD in 1996. By 2019, it had been used to treat a variety of mental health conditions by roughly 40 million people in the U.S. alone. 

Zoloft is often prescribed for OCD. It’s also prescribed — and FDA-approved — to treat mental health conditions like social anxiety disorder, depression, panic disorder, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). It’s also been prescribed off-label for conditions it’s not FDA-approved to treat, including generalized anxiety disorder (GAD), eating disorders, body dysmorphic disorder (BDD), and premature ejaculation.

Zoloft belongs to a class of drugs called serotonin reuptake inhibitors (SSRIs.) 

Serotonin is a natural chemical messenger or neurotransmitter. It sends electrical impulses from neuron to neuron in the brain. While serotonin is usually released and then reabsorbed into the neurons, SSRIs instead block the reabsorption (or reuptake) of serotonin back into the neurons, allowing more serotonin to remain between neurons. This increased level of serotonin between brain cells improves message transmission from cell to cell. 

While low serotonin levels are linked to mood disorders, SSRIs’ ability to increase the serotonin levels between brain cells appears to help relieve symptoms of OCD, depression, and other mental health conditions.

What is OCD?

Obsessive-compulsive disorder or OCD is a mental illness and diagnosis that causes obsessions or unwanted, intrusive thoughts, as well as compulsions or repetitive behaviors. It affects roughly 2.3% of adults in the U.S. and is more common in women than men.

For some people, the obsessive thoughts of OCD revolve around fear of germs or contamination, the need for order or balance, aggressive or taboo thoughts of harm or images related to sexuality, religion or aggression, or ruminations around doubt or decisions. 

Compulsions can take the form of repetitive behaviors like excessive hand washing, checking to see if a door is locked or the stove off, arranging objects in a certain way, seeking validation about memories (false memory OCD), or various other rituals. OCD sufferers think that if they complete the behavior in a specific way, they’ll find relief. But relief doesn’t come.

How is OCD treated with Zoloft?

If you have an OCD diagnosis, it’s best to seek care from a licensed healthcare professional. Your provider may decide to prescribe medication since the standard current treatment for obsessive-compulsive disorder includes both therapy and medication. 

If your provider decides to prescribe Zoloft, you’ll start at a small dose initially before increasing you to the most therapeutic dose. Psychiatrists and primary care physicians can prescribe Zoloft for both adults and children. It’s been found to be an effective long-term treatment for OCD, as well as the symptoms of anxiety and depression related to OCD. 

Does Zoloft work for OCD?

For some people, Zoloft does work for OCD. Studies support the effectiveness of Zoloft for the treatment of OCD. Zoloft for OCD reviews of research suggest that pharmacological treatment has historically been a key component in helping people reduce the severity of OCD symptoms.  

Research indicates that after 12 weeks of Zoloft drug treatment for OCD, quality of life improves for patients. 

Evidence-based research also indicates that the best results occur when OCD patients use an SSRI in combination with cognitive behavioral therapy therapies.

How long does Zoloft take to work for OCD?

Typically Zoloft starts to work in 1 to 2 weeks. Research indicates that, for OCD, it may take up to 12 weeks of treatment to see a significant difference. Full improvements in mood for depression often take 6 to 8 weeks.

It’s important to remember that each individual is different and individual experiences will vary. Your healthcare provider will work with you on the appropriate timeline and dose for your situation.

What does Zoloft do in the brain and body?

Zoloft functions by blocking the reabsorption of serotonin into neurons. This increases the level of serotonin in the gaps between neuron synapses and allows for additional messaging between the neurons or brain cells.

Increased communication between neurons is thought to improve mood and relieve symptoms of depression and anxiety disorders, including OCD. 

What’s the best Zoloft dose for OCD?

Zoloft is available in 25-milligram, 50-milligram, and 100-milligram oral tablets, as well as a 20-milligram/milliliter oral solution. 

The therapeutic dose for Zoloft is typically 50 to 200 milligrams. Your provider will start you off with a low dose, to let you adjust to it and monitor you for potential side effects or reactions Your dose may then be increased over 4 to 6 weeks until you reach your optimal dose or have adverse effects. At least one week between dose changes is recommended. 

Talk with a healthcare provider before starting or adjusting the dose of any medication. Your provider will consider factors such as age, medical history, and your response to treatment to determine the right starting and maintenance dose for you.

How is Zoloft taken?

Zoloft is taken by mouth. It can be taken in either the morning or evening, with or without food. Some people do find that taking this medication with food helps prevent nausea. Your medical prescriber will help you decide which form of Zoloft is best for you and when to take it.

What side effects does Zoloft have?

As with all medication, some people will experience side effects when taking Zoloft. Zoloft’s most common side effects in adults include:

• Nausea
• Loss of appetite
• Diarrhea
• Indigestion
• Tremors
• Shaking
• Increased sweating
• Anxiety
• Fatigue
• Change in sleep habits including increased sleepiness or insomnia
• Sexual problems like decreased libido or ejaculation failure

The most common side effects in children or adolescents include:

• Abnormal muscle movement or agitation
• Aggressive reaction
• Nose bleeds
• Urinary incontinence
• Slowed growth rate
• Weight change

Less common but serious side effects to look out for include:

• Suicidal thoughts and behaviors, especially in those under 24. If you have bipolar disorder, have a family history of mania or bipolar disorder, or are under 24 years of age, Zoloft may present a higher risk of serotonin syndrome and suicidal thoughts and behaviors. Zoloft carries an FDA box warning that signifies a potentially fatal risk. Children and patients between 18 and 24 in particular should be monitored for worsening or new suicidal thoughts or behaviors. 
• Serotonin syndrome, which may include symptoms like agitation, hallucinations, increased heart rate, coma, changes in mental status, racing heartbeat, high or low blood pressure, coordination problems or muscle twitching, nausea, vomiting, or diarrhea, sweating or fever, muscle rigidity.
• Increased risk of bleeding.
• Manic episodes marked by symptoms like excessively high energy, racing thoughts, trouble sleeping, and reckless behavior.
• Seizures or convulsions.
• Glaucoma.
• Changes in appetite or weight in children.
• Low sodium levels in the blood.

It’s important to seek medical care if you experience any exacerbated or new symptoms while taking Zoloft. If you or your child are taking Zoloft and experience sudden or extreme changes in mood/behavior or suicidal thoughts, seek immediate medical care or call 911. Monitor closely for changes, especially in young adults, teens, or children or after a dose increase.

What to know when considering Zoloft

When considering Zoloft for OCD, work closely with your healthcare provider. Zoloft isn’t suitable for everyone, and individual responses to medication vary. Some people shouldn’t take this medication and it won’t work for everyone. 

Zoloft, like all SSRIs, doesn’t work immediately. It may be a few weeks before you notice improvements.

What to avoid when taking Zoloft

If you start Zoloft, avoid taking it at different times of day and/or changing your prescribed dose without first talking to your healthcare provider. Taking your medication at a consistent time of day and dose is critical to making sure it’s as effective as possible. If you take any other medications, vitamins, or dietary supplements, discuss them with your provider to avoid  interactions with other medicines and/or natural supplements you take and contraindications, which are conditions or circumstances that suggest or indicate that you shouldn’t use Zoloft.

You should not take Zoloft within 14 days of taking a monoamine oxidase inhibitor (MAOI), such as intravenous methylene blue, isocarboxazid, linezolid, phenelzine, selegiline, or tranylcypromine because of an increased risk of serotonin syndrome.

You shouldn’t take Zoloft if you take pimozide because of the risk of may increase the risk of QT prolongation and heart arrhythmias. 

Avoid Zoloft if you’re sensitive to sertraline as it could lead to a severe allergic reaction that may include anaphylaxis or angioedema.

Avoid taking the oral solution of Zoloft, which contains alcohol if you take disulfiram, which can interact with alcohol. 

Don’t drive, operate heavy machinery, or engage in other activities that require you to remain alert until you know how Zoloft impacts you because it can cause drowsiness.

It’s generally recommended to avoid drinking alcohol with Zoloft since they both impact the central nervous system. Combining these substances can potentially cause sedation or increased side effects. 

If you have liver disease or renal impairment, platelet or bleeding disorder issues, glaucoma, a seizure disorder, or are over 65, don’t take Zoloft or generic sertraline without talking to your provider.

If you’re pregnant, may become pregnant, or are breastfeeding, your provider may or may not decide Zoloft is inappropriate for you depending on your case.

Your provider will consider your health history and potential conflicts with your health or medication use before prescribing you Zoloft.

What to know if stopping Zoloft

If you’re taking Zoloft, be aware that suddenly stopping it may cause withdrawal symptoms that may include:

• Nausea
• Severe mood changes, emotional lability, irritability, and/or agitation
• Dizziness
• Sweating
• Electric shock-like sensations
• Tremors
• Anxiety
• Tingling sensations or “pin-and-needles” (paresthesias)
• Headache
• Confusion
• Lethargy
• Trouble sleeping
• Hypomania (abnormally high energy behavior)
• Seizures
• Tinnitus (ringing in the ears)

Don’t stop taking Zoloft or reduce your dose without first talking to your healthcare provider.  

What other medications help OCD?

Zoloft isn’t the only OCD medication. There are other SSRIs that some medical prescribers may determine are the best or better for you. Some prescribers prefer tricyclic antidepressants for treating OCD. 

Some of the popular medications prescribed for OCD include:

Does therapy help OCD?

If you’re diagnosed with OCD, most providers recommend therapy in conjunction with medication treatment for OCD.

Research-based therapeutic modalities like cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and exposure therapy and response prevention (ERP) are used. ERP is considered the best therapy for OCD. 

You’ll likely need to see 2 separate providers — one for therapy and one for medication management. For medication treatment and management, you’ll see a psychiatric medication prescriber. For therapy, you’ll see a licensed therapist.

Therapy may help you address obsessive fears and compulsions, along with stress and anxiety management. Sometimes, family or couple’s therapy may also be indicated to support you in educating your family on how to cope with your mental health diagnosis in the healthiest way possible. 

This collaborative, team approach to treatment can support your neurochemical health while also providing you with practical, evidence-based coping tools and skills.

How to get a prescription for Zoloft

If you’re thinking about Zoloft for OCD, you first need to be diagnosed by a qualified healthcare provider, either online or in person. You’ll need to see a provider who can prescribe medications, which can include a psychiatrist, medical doctor, registered nurse, or physician assistant. You can find one of these providers on Klarity. 

Key takeaway

Zoloft (sertraline) is proven to help OCD patients find relief, especially when combined with evidence-based medical and behavioral therapies, such as cognitive therapy. While it can have side effects and shouldn’t be taken by everyone, it may be a good choice for you. To find out, start by talking with your healthcare team who can assess you for OCD and determine the right treatment approach.

Find a telehealth provider for an OCD prescription online 

If you or a loved one are struggling with OCD or OCD-like symptoms, you don’t have to struggle for long. Start toward relief by finding a caring, qualified, licensed healthcare provider on Klarity and have an appointment in as little as 48 hours.

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.