What to do if Zoloft makes your ADHD worse? (3+ better options)

If Zoloft (sertraline) is making your ADHD worse, you should reach out to your doctor right away. Zoloft is an antidepressant primarily used to manage depression, anxiety, and similar symptoms. It is not approved by the Food and Drug Administration (FDA) for the treatment of ADHD. (1)

So, you shouldn’t take Zoloft for ADHD treatment, as sertraline monotherapy won’t help you in any way. However, antidepressants might be used in combination with approved ADHD medications to manage ADHD combined with depression. 

However, SSRIs, including Zoloft, may exacerbate symptoms of ADHD, as such cases have been reported previously.

Why is Zoloft not typically used for ADHD?

Zoloft is not typically used for ADHD and is not approved for this condition because of how it works. Zoloft selectively inhibits the reuptake of serotonin by blocking serotonin transporters (SERT). (2)

This increases the availability of serotonin in the brain, and sertraline has little to no affinity for dopamine and norepinephrine levels. Serotonin is primarily involved in the pathophysiology of depression, but ADHD is much more complex than that. (3)

In this condition, norepinephrine and dopamine have to do a lot more than serotonin, which makes SSRIs like Zoloft not enough to manage the symptoms. 

Medications like psychostimulants affect the levels of all of these chemicals and increase the overall activity of the brain. This helps manage the symptoms of ADHD effectively.

What does research suggest?

Research studies have indicated that antidepressants are not adequate to manage symptoms of ADHD, and some might even exacerbate this condition. One research review discussed the use of antidepressants for ADHD and showed various responses. (4)

Some antidepressants, such as bupropion, can help with triggers or aggressive behaviour associated with ADHD. However, adverse events and a failure to achieve remission limit the use of antidepressants for ADHD, and they’re not as effective as psychostimulants (4). 

Furthermore, the study indicated that the rise of SSRIs, in particular, has not been tested enough, and these medications can aggravate ADHD symptoms. (4)

Another research study observed the use of SSRIs, including sertraline and fluoxetine, for the management of Major Depressive Disorder (MDD) comorbid with ADHD (5). 

The antidepressants did reduce the symptoms of depression to some extent, but no positive changes were observed in the symptoms of ADHD. These studies collectively suggest that sertraline, in no way, is a recommended option to treat ADHD, a condition so complex.

What are the clinical management strategies for ADHD?

The clinical management of ADHD typically involves the use of psychostimulants and psychotherapy. 

Non-stimulants are also employed in some cases to manage symptoms, and individuals may take more than one medication to address various symptoms related to ADHD and other common comorbidities. 

The most appropriate treatment varies based on individual-specific factors, and what works for one person may not always work for another. Common medications used to manage ADHD include: (6)

MedicationClassDosage Range
MethylphenidateStimulant10-60 mg/day (varies by type)
AmphetamineStimulant5-40 mg/day (varies by type)
AtomoxetineNon-Stimulant25-100 mg/day
GuanfacineNon-Stimulant1-4 mg/day
LisdexamfetamineStimulant30-70 mg/day
DexmethylphenidateStimulant5-40 mg/day

The choice of medications and doses can vary from person to person and should be determined by a qualified healthcare provider.

Taking antidepressants with ADHD

As per my experience as a pharmacist, I do not recommend sertraline monotherapy for ADHD. Even in the case of combination treatments, there are better antidepressants to use with ADHD medication to manage a variety of behavioural symptoms and depression. 

I also suggest considering psychotherapy, which is a constructive approach to managing ADHD. Psychotherapy or behavioural therapies provide a supportive space where individuals with ADHD can learn practical strategies to cope with their daily challenges. 

It helps them improve their time management skills and attention to detail. So, pairing psychotherapy with medication is essential for better management of ADHD.


  1. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf
  1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689
  1. Magnus W, Nazir S, Anilkumar AC, Shaban K. Attention Deficit Hyperactivity Disorder. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28722868. https://www.ncbi.nlm.nih.gov/books/NBK441838 
  1. Popper CW. Antidepressants in the treatment of attention-deficit/hyperactivity disorder. J Clin Psychiatry. 1997;58 Suppl 14:14-29; discussion 30-1. PMID: 9418743. https://pubmed.ncbi.nlm.nih.gov/9418743/ 
  1. Findling RL. Open-label treatment of comorbid depression and attentional disorders with co-administration of serotonin reuptake inhibitors and psychostimulants in children, adolescents, and adults: a case series. J Child Adolesc Psychopharmacol. 1996 Fall;6(3):165-75. doi: 10.1089/cap.1996.6.165. PMID: 9231310. https://pubmed.ncbi.nlm.nih.gov/9231310/ 

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