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Sertraline and Alcohol Interactions

What is Sertraline (Zoloft)?

Sertraline is a prescription antidepressant medication. It’s a selective serotonin reuptake inhibitor (SSRI), which means it enhances the function of nerve cells in the brain and ensures that serotonin levels don’t drop too low.

Sertraline works by rebalancing the brain’s chemicals. This reduces or eliminates feelings of depression, anxiety, or panic. This drug is also used to treat obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), anxiety and panic disorders, and premenstrual dysphoric disorder (PMDD).

Is Sertraline a Strong Antidepressant?

Sertraline is one of the most effective antidepressant medications available for treating mental health issues. It should only be used under the supervision of a healthcare provider.

Side Effects of Sertraline

The most common side effects of sertraline include:

  • Drowsiness
  • Dizziness
  • Fatigue
  • Insomnia
  • General weakness
  • Headaches
  • Nausea
  • Flatulence
  • Diarrhea
  • Abdominal pain
  • Abnormal sexual function or changes in libido
  • Hyperhidrosis
  • Tremor
  • Anorexia     

You should report any of the following side effects to your doctor immediately:

  • Dizziness
  • Drowsiness
  • Dry mouth
  • Diarrhea
  • Loss of appetite
  • Increased sweating
  • Nausea
  • Upset stomach
  • Trouble sleeping
  • Changes in sexual ability or interest
  • Bleeding or bruising
  • Shaking
  • Unusual weight loss
  • Weakness or muscle cramps
  • Suicidal thoughts

Seek immediate medical attention if you experience any of the following:

  • Black or bloody stools
  • Vomit with a grainy or coffee ground-like appearance
  • Eye pain or swelling or redness in the eyes
  • Widened pupils
  • Vision changes
  • Suicidal thoughts

Can You Drink Alcohol While Taking Zoloft?

Anyone using Sertraline or Zoloft should avoid drinking. It is usually safe to drink a small amount of alcohol, but it’s impossible to predict how your body will respond until you do it. The U.S. Food and Drug Administration (FDA) recommends avoiding mixing alcohol with Zoloft.

Drinking a lot of alcohol while using Zoloft or any other drug is dangerous. Both substances affect the work of your brain, which can produce a negative reaction. 

Side Effects of Sertraline and Alcohol

People taking sertraline and drinking alcohol might experience:

  • Anxiety
  • Depression
  • Diarrhea
  • Dizziness
  • Drowsiness
  • Headaches
  • Nausea
  • Suicidal thoughts

The most common side effect is drowsiness. Both alcohol and Sertraline are known to induce fatigue because both have a sedative effect.

It’s possible to develop an addiction to Sertraline and alcohol. If you are addicted and you stop using either substance, withdrawal is possible. Symptoms of depression and other mental health issues are also likely to arise when you change your use of sertraline and what you are combining it with.

Many symptoms associated with alcohol and Sertraline withdrawal are serious and require medical attention. You should seek immediate medical attention if you are using sertraline and alcohol and you stop and experience any of the following:

  • Cardiac Arrhythmia
  • Blood pressure imbalances
  • Confusion
  • Depression
  • Diarrhea
  • Difficulty controlling urination
  • Memory problems
  • Nausea
  • Panic attacks
  • Sexual dysfunction
  • Suicidal thoughts
  • Tremors
  • Vivid dreams

Risks of Sertraline and Alcohol Use 

Overdose is possible when using alcohol and sertraline. This is why you must carefully monitor your alcohol intake when using antidepressants. Not drinking alcohol when using sertraline is the only way to ensure you don’t overdose or experience any negative side effects from mixing these two substances.

Also, remember there are no guidelines for safe alcohol consumption when using sertraline. What is safe for someone else might not be safe for you. It all depends on your biological makeup and the type of alcohol you drink. Because of the unpredictable nature of alcohol with sertraline interactions, medical professionals encourage users to err on the side of caution.

Keep in mind, alcohol impairment occurs faster when drinking is combined with drugs. At the very least, sertraline users who drink alcohol should avoid:

  • Driving
  • Operating heavy machinery
  • Any activities that are dangerous for an impaired person to perform

Combining or misusing sertraline and alcohol can be fatal. The most common cause of a fatal reaction to the combination is serotonin syndrome. This occurs when there is an accumulation of serotonin in the brain. Symptoms of serotonin syndrome include:

  • Agitation
  • Confusion
  • Diarrhea
  • Fainting
  • Fever
  • Headaches
  • Hypertension
  • Restlessness
  • Shivering
  • Seizures
  • Tachycardia

Combining alcohol with an antidepressant can also lead to toxicity or poisoning. Symptoms of toxicity include:

  • Impaired mental and motor skills
  • Vision changes
  • Reduced inhibitions
  • Attention deficits

The detox and withdrawal process is also extended when SSRIs have been mixed with alcohol.

One study, published in the European Journal of Internal Medicine, showed that brainstem depression is possible when mixing sertraline and alcohol. This increases the risk of coma, respiratory depression, and death.

Suicidal thoughts are a risk for anyone using antidepressant medications. 

Alcohol Withdrawal Symptoms

If you are trying to quit drinking, you may experience challenging and unpleasant alcohol withdrawal symptoms. They can occur as soon as two hours following the last drink and can persist for four days or longer depending on the physical dependence level.

Symptoms can range from mild to severe.

Mild symptoms include:

  • Nausea
  • Anxiety
  • Shaky hands
  • Sweating
  • Insomnia
  • Vomiting

More severe symptoms of alcohol withdrawal include:

  • Hallucinations
  • Seizures
  • Delirium tremens

Delirium tremens (DTs) usually begin within 48 to 72 hours after your last drink. They are potentially life-threatening and extremely severe alcohol withdrawal symptoms. If you experience any of these symptoms or others, it is essential to seek medical help immediately.

Treatment for Sertraline and Alcohol Abuse

Sertraline and alcohol abuse requires medically supervised treatment.

You should follow the medical advice of your healthcare provider when stopping use of sertraline. This is especially true for those who began using sertraline recreationally. Someone who began using sertraline according to their doctor’s directions, but became addicted to mixing the medication with alcohol also needs assistance with a supervised detox.

Also, keep in mind someone with a co-occurring disorder who is abusing antidepressants and alcohol must receive medical attention for the original disorder during treatment. Successful treatment is only possible when all co-occurring disorders are treated.

A gradual taper is the safest way to stop using sertraline or any other prescription antidepressant, regardless of whether it was used recreationally or by prescription. This taper should occur under the supervision of a doctor.

Inpatient or outpatient recovery is the best option for someone addicted to sertraline and alcohol once they complete their detox and withdrawal. A recovery program that includes long-term sobriety goals can be paired with group and one-on-one counseling, family therapy, participation in a 12-step program, and more, based on the individual’s needs.

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Updated on March 29, 2022
6 sources cited
  1. Lau, G. T., and B. Z. Horowitz. “Sertraline Overdose.” Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, vol. 3, no. 2, 1 Feb. 1996, pp. 132–136
  2. “Sertraline (Oral Route) Side Effects - Mayo Clinic.”, 2020
  3. Menkes, David B, and Andrew Herxheimer. “Interaction between antidepressants and alcohol: signal amplification by multiple case reports.” The International journal of risk & safety in medicine vol. 26,3 : 163-70
  4. Singh HK, Saadabadi A. Sertraline. [Updated 2020 Nov 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan
  5. Duffy L, Lewis G, Ades A, et al. Antidepressant treatment with sertraline for adults with depressive symptoms in primary care: the PANDA research programme including RCT. Southampton (UK): NIHR Journals Library; 2019 Dec. (Programme Grants for Applied Research, No. 7.10.) Appendix 11, The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomised trial
  6. Antidepressants and alcohol: What's the concern?, Mayo Clinic, June 2017

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