What to do if Zoloft makes your anxiety worse? (3+ tips)

You can try the following things if Zoloft makes your anxiety wrote:

  • Talk to your doctor about treatment adjustment 
  • Stay patient. Your antidepressant will kick in
  • Engage in activities to distract yourself
  • Consider psychotherapy 

Talk to your doctor about treatment adjustment

If Zoloft is making your anxiety worse, talk to your healthcare provider. Zoloft tends to worsen anxiety before it starts making it better, and this is one of the most commonly reported side effects of this antidepressant (1,2). 

However, Zoloft-induced early anxiety is not expected to stay for too long, as Zoloft is a good anxiolytic. However, if your anxiety is too bad, your doctor may adjust your dose. Dose reduction helps a lot in the case of new Zoloft users or if your dose has recently been increased. 

This helps give your body more time to adjust to the medication. Once you respond well to it, your doctor can readjust your dose gradually. In some cases, combining Zoloft with an anxiolytic such as benzodiazepines for short-term use can help some people a lot with antidepressant-induced anxiety and insomnia (3). 

However, benzos are prescription medications and should not be taken without a doctor’s approval. Also, these medications might not be suitable for everyone, as they are Schedule IV drugs with a high potential for addiction and abuse.

Stay patient. Your antidepressant will kick in

Staying patient and giving your Zoloft enough time to work is important. As stated earlier, Zoloft-induced early side effects, including increased anxiety, start to get better with time as your body adjusts to the medication. 

It’s not uncommon for people to feel worse before they feel better on an antidepressant, and time has a lot to do here. So make sure you give Zoloft enough time to work and be strong. 

Once the antidepressant kicks in, it actively starts managing both your anxiety and depression and improves the overall quality of your life. This process takes time and it does not happen right away.

Engage in activities to distract yourself

It’s best to engage in distracting activities to help your mental health recover from depression and anxiety. These activities can help a lot and give your mind a break from never-ending anxiousness. 

It’s not just about how these things make you feel, but stress-reducing activities can release happy chemicals in your brain, complementing your Zoloft treatment. Some of these include:

ActivitiesEffects on Anxiety
Mindful MeditationPromotes relaxation, reduces racing thoughts, and enhances awareness.
Nature Walk or Outdoor MeditationConnects with nature, reduces stress hormones, and develops a sense of calm and peace.
Deep Breathing ExercisesCalms the nervous system, regulates heart rate, and induces a sense of tranquillity.
Restorative YogaRelaxes muscles, encourages mindfulness, and reduces overall stress and anxiety.
Working outReleases endorphins, improves mood, reduces stress, and enhances overall well-being.
JournalingProvides an outlet for emotions and helps organise thoughts.

Consider psychotherapy 

Psychotherapy, behavioural therapies, or one-on-one therapies are great ways to deal with your emotions (4). Talking about your worries and how things make you feel to someone who’s an expert in helping people process such emotions, someone you don’t know or related to, someone you know won’t judge you and is there to help. 

Such therapies can help you open up, and learn new ways that positively impact your thought processes. Psychotherapy, when paired with antidepressant monotherapy, can help manage your mental health condition safely and effectively.

Why does Zoloft worsen anxiety?

Zoloft may worsen anxiety by affecting serotonin levels in the brain. Zoloft, commonly known as sertraline, primarily inhibits the reuptake of serotonin by blocking serotonin transporters (SERT). This increases overall serotonergic activity in the brain which helps manage your anxiety and depression. (5)

Serotonin is an excitatory neurotransmitter that is primarily involved in the pathophysiology of depression. However, these changes in serotonin levels may make you feel more anxious or affect your sleep patterns. 

This happens because your body is not used to the increased serotonin levels, and it can make you feel weird during the early course of your treatment. Once your body adjusts to the medication, it gets better, and Zoloft starts managing your anxiety.


Managing early anxiety with Zoloft

In my experience as a pharmacist, I have come across many patients who consider discontinuing Zoloft because of increased anxiety during the early course of treatment. 

However, it does get better when the antidepressant kicks in. So, make sure you give the medication enough time to kick in and work closely with your provider to promote better recovery of your mental health. 


  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. National Library of Medicine. Sertraline: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https://medlineplus.gov/druginfo/meds/a697048.html
  1. Dunlop BW, Davis PG. Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review. Prim Care Companion J Clin Psychiatry. 2008;10(3):222-8. doi: 10.4088/pcc.v10n0307. PMID: 18615162; PMCID: PMC2446479. https://pubmed.ncbi.nlm.nih.gov/18615162/ 
  1. National Institute of Mental Health (NIH). Psychotherapies. Available from: https://www.nimh.nih.gov/health/topics/psychotherapies 
  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

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