Zoloft and Caffeine (Possible interactions) 

In this blog, we will talk about possible interactions between zoloft and caffeine. We will also discuss how they work so that we can easily understand which mechanism can result in possible interaction between these two chemicals. 

Zoloft and caffeine: Is there any interaction?

The interaction between zoloft and caffeine depends on how much you take it. Some studies suggest that antidepressants can inhibit the metabolism of caffeine. 

When the metabolism is affected, the chemical stays longer in your body as it normally should, hence it produces prolonged effects. 

A 2017 study found that low dose caffeine can enhance the efficacy of antidepressants in the treatment of major depression. A cup of coffee in the morning will not harm you as much as larger quantities will. 

Both zoloft and caffeine share some side effects like insomnia, digestive issues, irritability, nausea etc, so the use of high amounts of caffeine can cause synergistic effects

Synergistic effects are the combined effects of two or more substances, which are greater than the effects produced by any one of them individually. 

The combination may also cause symptoms of serotonin syndrome. Most commonly, insomnia and digestive issues are reported. They both are known to increase intestinal motility which results in diarrhoea. 

How does zoloft work?

Zoloft (sertraline) is one of the most commonly prescribed antidepressants. It belongs to the family of SSRIs, Selective serotonin reuptake inhibitors.

These drugs actually work by inhibiting the reuptake of serotonin from the synaptic cleft (space between a neuron and its target cell). Zoloft increases the availability of serotonin in your brain. 

Serotonin is a neurotransmitter (a chemical) released by our brain which is responsible for modulating mood, cognition, reward, learning, memory, and various other psychological processes. 

How does caffeine work?

Caffeine, on the other hand, is characterised as a CNS stimulant. It is stimulatory in nature and once inside your body, it binds to its respective receptors in your brain and causes alertness. 

Caffeine is also a part of some medications, like Panadol extra (paracetamol + caffeine), a product of GlaxoSmithKline. Such meds can be used to treat pain, tiredness, drowsiness and fatigue. It is also believed that drinking coffee can lower your risk of getting Alzheimer’s disease. 

Caffeine has a mild taste and it holds no nutritional value. It just provides you with energy, that’s all. The most widely used source of caffeine is coffee. For some, coffee is the first thing to go for in the morning, as stated earlier, it creates alertness. 

Caffeine is also recommended by fitness experts. Studies suggest that caffeine boosts metabolism, which helps burn calories. It is recommended to drink coffee before a workout session to enhance the calorie burning process.  

It is also suggested to drink after high fatty food consumption as it decreases the storage of fats in your body.

Risk of caffeine intoxication

Studies have shown that zoloft can interfere with caffeine metabolism, hence it is not broken down into its inactive metabolites. A chemical needs to be broken down before being eliminated from the body. 

This way more caffeine is available, for a prolonged period of time. It results in caffeine intoxication, which means enhanced and prolonged effects of caffeine.

Side by side comparison of side effects

Zoloft	Caffeine
Loss of appetiteTirednessFeeling angry or agitatedWeight gainInability to digest foodNauseaDiarrhoeaLoss of libidoSweating/Night sweatsTremors or shakingInsomniaDecreased sex driveImpotenceInability to release.	Anxiety Sleep disturbance or insomnia. It also decreases sleep qualityHeadachesDizzinessTachycardia Dehydration, as it causes diuresis Muscle painAddictionFatigueToleranceGastrointestinal issues like nausea, vomiting, diarrhoea etc.

Zoloft interaction with other foods and drinks

Zoloft interacts with the following foods and drink:

Grapefruit Juice

Grapefruit juice increases the level of zoloft in your body by inhibiting its metabolism. Be aware of using these two together. You might find more pronounced effects of zoloft, including adverse effects, as it will not convert into its inactive metabolite.

Cannabis

Do not use cannabis while you’re on zoloft. It will cause symptoms like confusion, panic attacks, seizures, anxiety, nervousness etc.

Tyramine rich foods

Tyramine is an amino acid. The combination of zoloft with tyramine rich foods, like cheese, milk, chicken liver, beef, avocados, bananas, canned figs, soy beans etc, can cause sudden and dangerous increase in your blood pressure.

Alcohol

Concomitant use of zoloft and alcohol may cause much more pronounced symptoms of depression and anxiety

Contraindication

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, if used concomitantly with non-steroidal anti-inflammatory drugs (NSAIDS), aspirin, anticoagulants like warfarin etc, can cause prolonged bleeding. 

Make sure you use your meds properly

It is extremely important to make sure that you take your medications as directed by your healthcare provider. Do not change the timing or dose without your doctor’s approval. 

Non-adherence, in case of antidepressants, makes your journey even more difficult. You are only supposed to take as recommended, not less or more than that. Both can result in exacerbating your condition. 

The medication comes with a guide, a leaflet. Follow instructions carefully. Ask your doctor if you have any query. 

Zoloft is available in tablet form as well as in oral liquid form. Oral solution comes with a measuring device. Measure the amount accurately using the given device. 

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.

When to consult a doctor 

Always contact your healthcare provider if you notice unusual side effects. In case of extreme diarrhoea, stop using caffeine (Do not stop zoloft abruptly). 

The synergistic effects of zoloft and caffeine can make your diarrhoea much worse than it usually is. If you experience following side effects, reach out to your healthcare provider as soon as you can:

• Seizure/convulsions
• Eye pain with vision problems
• Headache
• Confusion
• Agitation
• Memory problems/Dementia 
• Severe weakness and inability to move
• Hypothyroidism (low thyroid gland function)
• Bone marrow failure associated with low blood counts
• Thrombocytopenia
• Neutropenia 
• Abnormal behaviour/mania 
• Suicidal thoughts
• Feeling guilty all the time
• Extrapyramidal symptoms

These side effects are serious and you should not wait around for them to disappear on their own. Zoloft tends to induce suicidal behavior in users younger than 24 years of age. 

If you have someone who shows suicidal behavior or you see hopelessness in them, make sure you keep an eye on them and get medical attention as soon as you can.

Always discuss your existing medications with your doctor, even if you take any over-the-counter (OTC) drugs. Medication history is essential to make sure you stay safe from possible interactions. 

Conclusion

In this blog, we discuss the possible interactions between zoloft and caffeine. We also learned how zoloft and caffeine works. Zoloft and caffeine are known to produce synergistic effects, as they both share some common side effects.

The use of zoloft and caffeine together is not much of a problem. Make sure you do not take too much. Consuming anything in a moderate amount is not harmful for you. Always reach out to your healthcare provider, if you notice any unusual side effects.

FAQs: Zoloft and Caffeine

Can I drink coffee while taking 25 mg of Zoloft?

Yes, you can drink coffee with 25mg of zoloft, just do not overuse it. If you consume high amounts of caffeine while being on zoloft, they might end up causing synergistic side effects

Is it OK to drink coffee while taking sertraline?

It is okay to drink coffee while taking sertraline. Make sure you stick to moderate amounts.

What is it like to be on sertraline?

Sertraline is an antidepressant. It is used to treat symptoms of depression, anxiety, PTSD, OCD etc.

What are the side effects of zoloft?

Common side effects of Zoloft include:

• Loss of appetite
• Tiredness
• Feeling angry or agitated
• Weight gain
• Inability to digest food
• Nausea
• Diarrhoea
• Loss of libido
• Sweating/Night sweats
• Tremors or shaking
• Insomnia
• Decreased sex drive
• Impotence
• Inability to release

Zoloft, sometimes, causes serious side effects. Consult your healthcare provider as soon as you can if these symptoms occur:

• Seizure/convulsions
• Eye pain with vision problems
• Headache
• Confusion
• Agitation
• Memory problems/Dementia 
• Severe weakness and inability to move

Can caffeine treat depression?

Caffeine induces alertness by acting on the central nervous system. Study suggests caffeine might help in taking depressive symptoms down a notch. Make sure you avoid overusing it. Caffeine is a chemical itself and it has side effects of its own. These include:

• Anxiety 
• Sleep disturbance or insomnia. It also decreases sleep quality
• Headaches
• Dizziness
• Tachycardia 
• Dehydration, as it causes diuresis 
• Muscle pain
• Addiction
• Fatigue
• Tolerance
• Gastrointestinal issues like nausea, vomiting, diarrhoea etc

Does caffeine stop antidepressants?

No, caffeine does not stop antidepressants. Study suggests there is no relationship between the use of caffeine and plasma concentration of antidepressants. 

Caffeine does not interfere with the absorption of such meds in your blood but antidepressants are known to slow down caffeine metabolism.

Does caffeine affect serotonin?

Caffeine can decrease serotonin overtime if used in higher quantities but it does increase the release of dopamine which can make you feel less depressed. 

References 

• Aleksandra Szopa, Ewa Poleszak,corresponding author Elżbieta Wyska, Anna Serefko, Sylwia Wośko, Aleksandra Wlaź, Mateusz Pieróg, Andrzej Wróbel, and Piotr Wlaź – Caffeine enhances the antidepressant-like activity of common antidepressant drugs in the forced swim test in mice https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715838/
• James M. Ferguson, M.D.- SSRI Antidepressant Medications: Adverse Effects and Tolerability https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/
• Sertraline and its interaction with caffeine, alcohol, foods and herbs https://www.medindia.net/drugs/drug-food-interactions/sertraline.htm
• Pamela J Broderick 1, Ashley B Benjamin, Leland W Dennis – Caffeine and psychiatric medication interactions: a review https://pubmed.ncbi.nlm.nih.gov/16206866/
• Caffeine – https://www.drugs.com/caffeine.html
• Marta Kot, Jacek Wójcikowski, Władysława A Daniel (2007) – Caffeine metabolism during prolonged treatment of rats with antidepressant drugs https://pubmed.ncbi.nlm.nih.gov/18195463/
• Qing-Shan Liu, Ran Deng, Yuyan Fan, Keqin Li, Fangang Meng, Xueli Li, Rui Liu (2017) – Low dose of caffeine enhances the efficacy of antidepressants in major depressive disorder and the underlying neural substrates https://pubmed.ncbi.nlm.nih.gov/28054436/