Taking zoloft at night (An overview) 

This blog will help you understand the benefits, as well as well as drawbacks, of taking zoloft at night. We will discuss how zoloft usually works, its upsides and downsides.

We will also learn how we should use zoloft to achieve its maximum beneficial effects while avoiding as many side effects as we possibly can. 

Zoloft is actually a brand name for the most commonly used antidepressant, called Sertraline. It is a prescription medication used to treat mild to severe episodes of depression.

Reasons why you should take zoloft at night

It’s best to take zoloft at night if you suffer from following side effects:

Drowsiness/Tiredness/Fatigue

If zoloft makes you drowsy, it’s better to take it at night. In this way you can avoid getting sleepy during the day time. Antidepressant associated drowsiness is more common in other classes of antidepressants, such as Tricyclic antidepressants (TCAs), Serotonin-norepinephrine reuptake inhibitors (SNRIs) etc. 

Nausea 

Zoloft is known to trigger nausea, as well as vomiting, diarrhoea and loss of appetite. This is because high serotonin levels can be overwhelming for your stomach. In such conditions, it is best to take zoloft at night, in order to avoid such side effects. 

Reasons why you should not take zoloft at night

Some side effects associated with zoloft make your night time quite unbearable. It is best to switch your antidepressant from night to morning, if it causes following side effects:

Insomnia

Some SSRIs, including zoloft, tend to decrease your sleep quality and can cause insomnia. If your antidepressant is keeping you up all night and making it difficult for you to fall asleep, it’s best to take it in the morning. 

This way, the effects of the drug will be minimal when you go to bed. Hence, you will experience less sleep disturbance. 

Urinary problems 

Zoloft can cause frequent urination as well as urinary incontinence in children and adolescents. In this case, it’s best to take zoloft in the morning to avoid bedwetting.

Sexual issues

If zoloft makes you go through sexual issues, such as low libido, erectile dysfunction, or inability to ejaculate, it is extremely important to set an appropriate time to take you medication. 

Studies suggest it’s best to counteract sexual side effects by taking antidepressant after the time you usually spend being sexually active. This means that you can take zoloft early in the morning which can help you to avoid sexual side effects at night. 

Upsides of zoloft 

• Zoloft is widely used in the treatment of mild to severe depression. 
• It is known to reduce anxiety in people with obsessive compulsive disorder (OCD). 
• It is also used to tone down the intensity and frequency of panic attacks. 
• It is also approved to treat post-traumatic stress disorder (PTSD), relieving symptoms such as avoidance and intrusion. 
• It is known to reduce the symptoms of social anxiety disorder. 
• Zoloft is also used to treat premenstrual dysphoric disorder, including symptoms like mood swings, irritability, bloating, and breast tenderness.

Downsides of zoloft 

• Zoloft causes common side effects like sleepiness, fatigue, feeling anxious or agitated, inability to digest, nausea, weight gain, diarrhoea, loss of appetite, night sweats, tremors or shaking, sleep problems (insomnia), loss of libido. 
• Skin allergy, which could include Stevens-Johnson. You might notice red, swollen, or blistered skin, with or without fever. 
• Allergic reactions, like rash, hives are common. It also includes wheezing, difficulty in breathing, tightness in the chest, trouble breathing, swallowing, or swelling of the mouth, face, lips, tongue, or throat. Few of these symptoms indicate anaphylactic shock. 
• It could cause low sodium levels which can result in psychological symptoms like confusion, agitation, inability to understand surroundings, memory loss etc.
• Zoloft and other SSRIs possess a risk of bleeding when used with non-steroidal anti-inflammatory drugs (NSAIDs), warfarin or other anticoagulants. 
• It can cause manic episodes, in which people behave erratically and are often confused or worried. 

Who should not take zoloft? 

Zoloft is not for everyone. For people living with pre-existing health conditions, it is crucial to rule out any drug-disease interaction. 

People with bipolar disorder

Taking zoloft might trigger mania in people with bipolar disorder. If you have this condition, talk to your doctor before using this med. 

People who suffer from convulsions 

The use of this drug increases your risk of having seizures. Consult your healthcare provider to make sure if the use of zoloft is safe for you in this condition or not.

People with glaucoma

Zoloft may trigger a glaucoma attack. Talk to your doctor before taking Zoloft if you have this condition. 

People with chronic kidney diseases

If your kidney function is compromised you may not be able to clear this drug out. When the drug is not properly eliminated, it starts getting accumulated in the blood which, in simple words, means more side effects.

People with chronic liver diseases

If your liver function is compromised, your body might not metabolise this drug effectively. This increases the level zoloft in your body and causes more side effects

Interactions 

Do not use zoloft with any irreversible monoamine oxidase inhibitors (MAOIs). Concomitant treatment is highly contraindicated due to the risk of serotonin syndrome with symptoms like agitation, tremor and hyperthermia. 

Zoloft must not be initiated for at least 14 days after discontinuation of treatment with an irreversible MAOI. Zoloft must be discontinued for at least 7 days before starting treatment with an irreversible MAOI.

Do not use zoloft with pimozide. Combining these medications can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.

Zoloft also interacts with tryptophan, St. John’s wort, meperidine, tramadol, cimetidine, and warfarin. Use of Zoloft during the 3rd trimester of pregnancy can cause adverse effects in the newborn. 

Ensure proper use of zoloft

• Do not deviate from the dose prescribed by your healthcare provider. 
• If you fail to understand how to use the drug properly or have any other question, ask your doctor or pharmacist.
• In case of overdose, immediately reach out to the hospital. Make sure you properly guide them about how much drug you have taken and when. 
• If you experience unusual side effects, immediately contact your healthcare provider.
• Oral solution of zoloft comes with a measuring device. Measure the amount accurately. You can dilute it in water. If water is too bland for you, you can mix it in some lemonade, ginger ale or lemon soda, to mask the taste better.
• Tablets can be taken with food or on an empty stomach. It’s best to eat something before taking it, in order to avoid acid reflux. Make sure you take it as directed by your healthcare provider. 

When to call your doctor

In case you experience any unusual side effect, report to your healthcare provider as soon as you can. Not every side effect goes away on its own. It’s best to consult your doctor and make sure your side effects do not require urgent treatment. 

If you wish to change the time at which you take your med, discuss the best switching strategy with your doctor. It is not recommended to change your dose or time without medical guidance. 

If you wish to shift from morning to night, it is recommended to skip your morning dose and take it at night instead, from where you can continue taking it at night. 

If you wish to shift from night to morning, it is recommended to skip your night dose and take it in the following morning, from where you can continue taking zoloft every morning. Try to take your med at the same time everyday in order to have a perfect gap between the two doses. 

Conclusion 

To sum up it all, use zoloft in accordance with your side effects. If it causes insomnia, sexual issues or urinary problems, take it in the morning as these side effects will be more pronounced at night. If zoloft causes drowsiness or nausea, take it at night. 

Although, it’s best to discuss your symptoms with your healthcare professional and follow his advice. Always report unusual side effects. Do not just sit back and wait for them to go away on their own. 

FAQs: Taking zoloft at night

Can I take Zoloft at night?

Yes, you can take zoloft at night. Infact, it’s best to take it at night if it causes drowsiness, tiredness or nausea.

Why is it better to take Zoloft at night?

It’s best to take zoloft at night if you suffer from following side effects 

Drowsiness/Tiredness/Fatigue

If zoloft makes you drowsy, it’s better to take it at night. In this way you can avoid getting sleepy during the day time. Antidepressant associated drowsiness is more common in other classes of antidepressants, such as Tricyclic antidepressants (TCAs), Serotonin-norepinephrine reuptake inhibitors (SNRIs) etc. 

Nausea 

Zoloft is known to trigger nausea, as well as vomiting, diarrhoea and loss of appetite. This is because high serotonin levels can be overwhelming for your stomach. In such conditions, it is best to take zoloft at night, in order to avoid such side effects. 

Can taking Zoloft at night cause insomnia?

Zoloft is known to cause sleep disturbances but it is also known to cause tiredness or drowsiness. So, if zoloft is making you insomniac or is disrupting your sleep quality, do not take it at night. 

Can’t sleep after taking sertraline?

As stated earlier, zoloft affects people differently. If you find falling asleep difficult after taking zoloft, it means it is causing insomnia in you. Switch taking zoloft from night to morning.

Can I take sleeping tablets while on sertraline?

It is not safe to take sleeping pills along with sertraline (Zoloft) . Zoloft increases the availability of serotonin, which is an excitatory neurotransmitter, while sleeping pills mimic inhibitory neurotransmitters like GABA. They might cause impairment in thinking, judgement, and motor coordination.

Will I gain weight on Zoloft?

It depends. Zoloft causes some people to gain weight by spiking their cravings for high carb food like pasta, bread, desserts etc, while it causes some people to lose their appetite, which results in weight loss.

References

• C Lindsay DeVane et al. Clin Pharmacokinet. 2002. – Clinical pharmacokinetics of sertraline https://pubmed.ncbi.nlm.nih.gov/12452737/
• James M. Ferguson, M.D. – SSRI Antidepressant Medications: Adverse Effects and Tolerability https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/
• Zoloft tablets, for oral use; Zoloft (sertraline hydrochloride) oral solution (2021). https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=fe9e8b7d-61ea-409d-84aa-3ebd79a046b5&type=display
• Sleep and Sleep Disorders – Centers for disease Control and Prevention (CDC) https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html
• Samantha J Thomas 1, Mirae Shin, Melvin G McInnis, Jolene R Bostwick – Combination therapy with monoamine oxidase inhibitors and other antidepressants or stimulants: strategies for the management of treatment-resistant depression (2015) https://pubmed.ncbi.nlm.nih.gov/25884531/