Zoloft and Alcohol: What You Need to Know

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
March 30, 2022

Almost 70 percent of American adults have had alcohol in the past year.

Many people have a drink to relieve stress or to feel better when they’re down.

But the feeling doesn’t last: Alcohol is a central nervous system depressant, meaning that when the potentially euphoric effects of alcohol wear off, you can feel worse. 

If you believe you’re one of the more than 20 million American adults who has had a major depressive incident in the last year, or if you’re one of the 40 million adults experiencing anxiety, alcohol is not an effective treatment for your symptoms, and will likely make your symptom worse over time.

If you’re experiencing depression and anxiety, your doctor may prescribe you Zoloft, an antidepressant medication, to help regulate your mood. 

If your doctor prescribes you Zoloft or another antidepressant, drinking alcohol while you’re taking the medication may make your antidepressant or anxiety medication less effective, or cause increased side effects.

In this article, I’ll talk about whether it’s OK to mix alcohol with Zoloft.

I’ll first tell you what Zoloft is, and how it’s used.

I’ll then discuss how the medication can interact with alcohol, and when you can start safely drinking again.

I’ll provide a few precautions and warnings, and tell you when to talk to your doctor.

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What is Zoloft and How is it Used? 

If you have been dealing with depression, anxiety, panic attacks, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or social anxiety disorder (social phobia), your doctor or mental health provider may prescribe you Zoloft to treat your symptoms.

Zoloft is a brand name for sertraline hydrochloride.

It is a type of antidepressant called a selective serotonin reuptake inhibitor, or SSRI.

SSRIs work by boosting the serotonin levels in your brain. Serotonin is a type of neurotransmitter, a molecule used by your nervous system to carry messages between neurons, between the nervous system and muscles, or between the nervous system and the brain. 

Serotonin helps humans think, learn, and remember.

It also helps stabilize mood, balance emotions, regulate appetite, and improve sleep, among other things. Healthcare clinicians aren’t sure whether low levels of serotonin cause major depression and other mental illnesses or vice versa.

We do know that using medications and other treatments to boost and rebalance serotonin levels can positively impact a patient’s mental well-being and quality of life.

Zoloft was first approved for medical use in 1991 by the U.S. Food and Drug Administration (FDA).

It is only available by prescription.

Sertraline is taken orally, in pill or concentrated liquid forms, typically once a day in the morning or evening.

If it is being used to treat premenstrual dysphoric disorder (PDD), the dose may be prescribed once a day, either every day of the month or on certain days of the month.

Zoloft and Alcohol Effects 

It is not uncommon for people with depression to reach for a glass of wine or two as a way to cope, even when they are taking Zoloft or other antidepressants.

While this may make you feel better in the short term, alcohol can cause a worsening of depression and anxiety over time.

It is strongly advised not to mix alcohol and Zoloft.

The combination can intensify side effects and make Zoloft less effective in treating your depression. 

If you drink alcohol while taking sertraline, you may experience the following side effects more intensely: 

  • Difficulty sleeping
  • Dizziness
  • Excessive sedation
  • Fatigue
  • Headaches
  • Slowed breathing
  • Stomach problems

Consult with your doctor or mental health provider if you are currently taking Zoloft and are unable to abstain from alcohol.

They will be able to guide you toward the necessary resources to help you quit, as well as inform you of the potential risks of drinking while taking sertraline.

Zoloft Side Effects 

Typically, mild side effects of Zoloft will taper off after the first week as your body gets used to the medication.

Some common side effects include:

More serious side effects require medical attention.

These include:

  • Suicidal thoughts or actions
  • Seizures or convulsions
  • Symptoms of serotonin syndrome
  • Difficulty breathing
  • Fast, irregular heartbeat
  • Skin rash or hives
  • Swelling of the face, lips, tongue, or throat
  • Black or bloody stools
  • Shaking
  • Unusual weight loss
  • Vision changes or blurred vision
  • Vomiting 

Serotonin syndrome

Serotonin syndrome is a serious condition where your serotonin levels are too high, resulting in potentially life-threatening side effects.

Since Zoloft blocks the normal uptake of serotonin and increases your serotonin levels, it can increase your risk for serotonin syndrome, especially at higher doses or when combined with other medications.

Symptoms of serotonin syndrome include:

  • Confusion
  • Agitation 
  • Restlessness
  • Hallucinations
  • Headache
  • Dilated pupils
  • Nausea
  • Vomiting
  • Diarrhea
  • High blood pressure
  • Rapid heart rate
  • Tremors, shivering, or goosebumps
  • Loss of muscle control or coordination
  • Twitching muscles or muscle rigidity
  • Heavy sweating
  • Seizures
  • Hallucinations
  • High fever

If you exhibit any signs of serotonin syndrome, talk to your healthcare provider.

If you pass out, experience seizures, confusion or hallucinations, have a high fever, or have an irregular or very rapid heartbeat, seek emergency  medical attention immediately.

When Can You Consume Alcohol Again?

Skipping Zoloft to drink can result in the medication not working effectively and result in withdrawal symptoms.

It is not advised that you skip a dose unless under the instructions of your healthcare provider.

It can take several days for Zoloft to completely leave your body. 

Never stop taking an antidepressant suddenly.

If you want to stop taking Zoloft, you should speak with your healthcare provider regarding stopping the medication.

They may taper you off the drug, and will be able to guide you on when it’s safe for you to start consuming alcohol again.

However, since alcohol can make anxiety and depression symptoms worse, we recommend significantly limiting or avoiding alcohol use whether or not you are taking an antidepressant.

Precautions and Warnings 

Before taking Zoloft, tell your prescriber if you are allergic to it or have any other known allergies.

Tell your provider about any other medications you are taking, including over-the-counter medications and supplements, to avoid negative drug interactions.

There are several SSRIs and other medication types that work effectively in treating depression and anxiety.

Tell your doctor or mental health provider about your medical history and symptoms, as well as any alcohol, drug, or supplement use, so they can prescribe the best one for you.

How does alcohol affect depression?

Alcohol can temporarily increase serotonin and dopamine levels, which help regulate your mood.

You may feel better when you drink, but this feeling won’t last.

Alcohol can exaggerate depressive symptoms because it depresses the central nervous system.

After the effects of alcohol have worn off, you may become more depressed and anxious as your serotonin and dopamine levels fall

When you mix this with Zoloft, you may experience a short-term high.

But this can cause a worsening of your symptoms of depression and anxiety in the long run, as your mood becomes irregular as a result of the fluctuations in brain chemicals. 

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When to See a Doctor 

Do not stop taking Zoloft without medical supervision.

Talk with your doctor or prescriber if you wish to lower your dose or stop the drug.

They will be able to determine the best treatment for you. 

If you are experiencing worsening symptoms while taking Zoloft, talk to your healthcare provider.

Seek medical attention immediately for any of the following serious side effects:

  • Suicidal thoughts or tendencies
  • Seizures
  • Manic episodes: unusual risk-taking behavior, rapid speech, extreme happiness, being irritable, and increased energy
  • Hallucinations, memory loss, confusion, or headaches
  • Shivering
  • Sweating
  • Vomiting
  • Diarrhea
  • Accelerated or irregular heart rate 

How K Health Can Help

Think you might need a prescription for Zoloft (Sertraline)?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine if Zoloft is right for you.

Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

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