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Last updated: Jul 08, 2021
5 min read

Zoloft and alcohol: risks and side effects

Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant and anti-anxiety medication. If you take Zoloft, it’s best to avoid drinking alcohol because the combination could increase your risk of side effects or worsen the symptoms of depression.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

If you’re taking Zoloft or considering it as a new treatment, you may want to know if it has any interactions with alcohol. Drinking alcohol affects your central nervous system (CNS), which includes your brain. Since Zoloft works in your brain as well, the combination can increase your risk of harmful side effects. Read on to learn what to know about Zoloft and alcohol.  

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What are the side effects of drinking alcohol with Zoloft?

Zoloft (sertraline; see Important Safety Information) can make you feel sleepy, less alert, or affect your ability to think and react quickly. These side effects are more common when you first start taking the drug. It’s not recommended to drive or operate heavy machinery until you see how Zoloft affects you. 

Since alcohol carries the same risks of drowsiness and impairment, it’s not safe to mix with Zoloft. Also, some of the more common side effects of Zoloft could be made worse by drinking alcohol due to additive effects, such as (Pfizer, 2016):

  • Nausea
  • Diarrhea or loose bowel movements
  • Indigestion
  • Increased sweating
  • Sexual side effects such as difficulty with ejaculation

What is Zoloft?

Zoloft is a brand-name prescription medication. It’s an antidepressant that was approved by the Food and Drug Administration (FDA) in 1991. Here are a few quick facts about Zoloft (Pfizer, 2016):

  • Drug class: selective serotonin reuptake inhibitor (SSRI)
  • Generic name: sertraline
  • Form: tablet and oral liquid solution
  • Strengths: 25 milligrams (mg), 50 mg, 100 mg, and 20 mg/mL
  • Usual dosing frequency: once a day

Zoloft is FDA-approved for adults and some children to treat the following conditions:

Besides its FDA-approved uses, Zoloft is sometimes prescribed for other, “off-label” uses, such as binge eating disorder, body dysmorphic disorder, bulimia nervosa, generalized anxiety disorder, and ejaculation disorders (Singh, 2020).

Like all antidepressants, Zoloft comes with a Black Box warning from the FDA due to an increased risk for suicidal thoughts and behaviors. This risk is higher in young adults under age 25, teenagers, and children, especially during the first few months of treatment or after dose increases. Because of this warning, your doctor will carefully monitor you for signs of worsening depression (Rush, 2021).

Risks of mixing alcohol with Zoloft

According to Pfizer (the brand drug’s manufacturer), in clinical studies, Zoloft did not increase the short-term mental and physical side effects of alcohol (Pfizer, 2016). However, it’s still recommended not to drink alcohol while you’re taking Zoloft. Why is that?

Chemically, alcohol is a depressant. It influences mood, feelings, and actions and could worsen the symptoms of depression. Alcohol consumption has been linked to negative effects on mental health and impaired judgment (Iranpour, 2019). Even though drinking alcohol may seem to relieve stress temporarily, it can make depression symptoms worse. Long-term alcohol use increases the risk of severe depression and anxiety (Iranpour, 2019).

Long-term alcohol use can also cause physical changes in the serotonin receptors in your brain that could lead to physical dependence on alcohol, alcohol abuse, and alcohol use disorder (AUD) (Lovinger, 1997). With AUD, increased anxiety levels can occur when you attempt to stop drinking. 

Drinking alcohol in moderation can also interfere with how well your treatment works for your condition. Studies have found that even moderate alcohol use negatively impacts depression. Some people may be more sensitive than others to the effects of alcohol on their depression symptoms and treatment. Also, research has shown that people with a history of moderate alcohol use are more likely to quit taking their medication treatment (Ramsey, 2005).

It’s best not to stop taking your antidepressant without first discussing other treatment options with your healthcare provider.

 FAQs about Zoloft and alcohol

Here are some common questions you may have about taking Zoloft with alcohol.

If I take Zoloft in the morning, how many hours afterward is it safe to drink alcohol?

There’s no safe amount of time of day to drink alcohol if you’re taking Zoloft. In fact, even if you stop taking Zoloft, it’ll take 5–6 days for your last dose to be cleared from your body. If you’re an older adult (age 65 years or older) or have liver problems, it may take longer (Pfizer, 2016). 

Can I skip taking Zoloft for a day, weekend, or vacation if I want to drink alcohol?

It’s not recommended to skip doses of your antidepressant. You shouldn’t temporarily or suddenly stop taking Zoloft or any medication without consulting your healthcare provider. Skipping doses of antidepressants can make them less effective for your depression or anxiety. 

Also, suddenly stopping Zoloft can cause withdrawal symptoms that you may not want to happen, especially during your vacation. Withdrawal symptoms can include nausea, sweating, mood changes, irritability, dizziness, electric shock-like sensations, anxiety, confusion, headache, trouble sleeping, ringing in the ears, or seizures (Pfizer, 2016).

Can one alcoholic beverage with Zoloft really put me in danger?

If you take Zoloft, it’s not likely that one serving of alcohol will be life-threatening. According to the Centers for Disease Control and Prevention (CDC), examples of one serving of alcohol include a 12-ounce beer (5% alcohol-by-volume or ABV), a 5-ounce glass of wine (12% ABV), or 1.5 ounces of liquor (40% ABV) (CDC, 2021). 

However, the problem is that having one alcoholic beverage can lead to more. Drinking alcohol is known to impair your judgment and may lead to choices that you wouldn’t make if you were sober. It’s also known that excessive alcohol use itself can be dangerous and is responsible for more than 95,000 deaths in the United States every year  (Esser, 2020).

The dangers of drinking alcohol with Zoloft are serious, so why put yourself at risk? It’s best not to assume that any amount of alcohol is safe with Zoloft.

I read that the liquid form of Zoloft contains alcohol. Does that mean it’s safe to drink alcohol with it?

No, it would be best if you didn’t drink alcohol with any form of Zoloft. In addition to tablets, Zoloft is available as an oral liquid. It contains 12% alcohol as part of its ingredients. This may sound strong, but the usual dosage is only a teaspoonful or less per day, and it must be diluted in water or juice before taking. And, of course, it contains sertraline, the active drug in Zoloft, which isn’t recommended in combination with alcohol due to an increased risk of side effects and worsened depression.

Talk to a healthcare professional

If you’re still thinking of drinking alcohol with Zoloft, it’s important to first talk to your doctor or healthcare provider. They can make a recommendation for you based on your condition, treatment goals, and personal medical history.

If you feel like you can’t stop drinking alcohol or frequently drink more than you wanted to, talk with your healthcare professional. They can identify treatment programs and provide medical advice to help you.

References

  1. Centers for Disease Control and Prevention (CDC). (2021). Alcohol use and your health. Retrieved from  https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
  2. Esser, M. B., et al. (2020). Deaths and years of potential life lost from excessive alcohol use — United States, 2011–2015. Morbidity and Mortality Report Weekly, 69(39);1428–1433. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/mm6939a6.htm
  3. Iranpour, A., & Nakhaee, N. (2019). A review of alcohol-related harms: A recent update. Addiction & Health, 11(2), 129–137. doi: 10.22122/ahj.v11i2.225. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6633071/
  4. Lovinger D. M. (1997). Serotonin’s role in alcohol’s effects on the brain. Alcohol Health and Research World, 21(2), 114–120. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826824/
  5. Pfizer. ZOLOFT (sertraline hydrochloride) tablets, for oral use. (2016). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839S74S86S87_20990S35S44S45lbl.pdf
  6. Ramsey, S. E., Engler, P. A., & Stein, M. D. (2005). Alcohol use among depressed patients: The need for assessment and intervention. Professional Psychology, Research and Practice, 36(2), 203–207. doi: 10.1037/0735-7028.36.2.203. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874911/
  7. Rush, JA. (2021). Effect of antidepressants on suicide risk in adults. In: UpToDate. Retrieved from https://www.uptodate.com/contents/effect-of-antidepressants-on-suicide-risk-in-adults
  8. Singh, H.K., Saadabadi, A. (2021). Sertraline. [Updated 2020 Nov 22]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK547689/