Nausea From Zoloft
Sertraline, most commonly known as Zoloft, is the most prescribed antidepressant in both the US and UK. This is partially due to its effectiveness, but mainly thanks to its relatively favorable side effects profile. That said, it's not completely without side effects.
Nausea is the most common side effect of Sertraline, reported in about a fourth of patients taking the medication. When I prescribe Sertraline, it's the first potential side effect I talk about to my patients.
So what should you do if it happens to you? In this short article, I explain my go-to suggestions and things you need to know.
Unpleasant, But It Usually Passes
The nausea from Sertraline usually sets in an hour or two after taking the pill. It can range from an hour of mild queasiness to the kind of intense nausea that leads to vomiting, occurring in about 4% of the patients.
For most people taking Zoloft, the nausea is temporary. It usually only occurs for a few days, sometimes up to two weeks, before passing as the body adapts to higher serotonin levels. This is also why it helps to start low and slowly increase the dosage, as the body will more likely tolerate the drug.
For a minority of patients, the nausea does not pass or is not manageable. Depending on the severity, you may have to think about swapping to an antidepressant without gastrointestinal side effects (see chart). You should immediately contact your doctor if you’re regularly vomiting due to nausea, as that can lead to dehydration and dangerous electrolyte imbalances.
Rule Out Other Causes
Not all nausea that appears after starting Sertraline is necessarily caused by the medication itself. Before assuming it is a side effect, it’s worth considering other possible explanations. Common culprits include gastroenteritis ("stomach flu"), anxiety, dehydration, excessive caffeine, or even pregnancy.
The timing of the nausea will be your must-telling factor connecting it to the medication or something else. Regular nausea a couple of hours after taking the medication in the morning? Likely nausea from Sertraline rather than something else.
In some cases, what feels like nausea is actually dyspepsia, meaning reflux or heartburn. Dyspepsia is also a common side effect of Sertraline. If that’s the case, dealing specifically with those problems may ease the nausea.
Using Medications Against Nausea
The nausea from taking Zoloft mainly happens because of increased serotonin stimulating the 5-HT3 receptors in the gastrointestinal tract.
Some people quickly turn to medications for nausea relief, and yes, there are antiemetic drugs that block 5-HT3, such as Ondansetron, which can potentially help. Combining these drugs with antidepressants may present a danger.
WHO & FDA Warnings
However, the World Health Organization (WHO) and the US Food and Drug Administration (FDA) have issued warnings about a potential risk of serotonin syndrome when certain nausea medications, specifically 5-HT3 blockers, are combined with drugs like Sertraline.
This position has been criticized for being pharmacologically questionable. To be safe, you should never combine these medications before speaking to your doctor.
When It May Be Considered
Using antiemetics should most likely only be considered if Sertraline is the only antidepressant that works for you, or if others are ruled out for definite reasons. If you’re in that situation, talk with your doctor and carefully weigh your options.
5 Safe Tips To Reduce Nausea From Zoloft
If your nausea is mild to moderate, or you just want to get through the first couple of weeks, there are easier and accessible home tricks and remedies that can make a difference.
1. Take it in the evening.
My go-to suggestion is to take the medication in the evening so that patients sleep through the worst of the nausea. The potential downside is that Sertraline can also cause activation and sleeping difficulties. Talk to your doctor in case that happens.
2. Eat before taking it.
Make sure you eat a proper meal before taking the medication. Food lowers the risk of upsetting the stomach. You could also try snacking on something light throughout the day.
3. Try gentle remedies.
Some home remedies like ginger tea may also help. Peppermint tea or sucking on peppermint candies can sometimes ease mild nausea as well.
4. Get some fresh air.
Fresh air and a short walk outside can sometimes reduce nausea as well. Aim for low-medium pace walking for 20-30 minutes. Colder air may be more effective than hot, humid air.
5. Isopropyl alcohol wipes for emergent relief
If nothing else helps, smelling isopropyl alcohol (rubbing alcohol) wipes as a short-term emergency solution to severe nausea is generally considered safe, according to a scientific study from 2016. However, frequent or recurrent inhaling of isopropyl alcohol can be harmful and should be avoided.
When to Call Your Doctor
If possible, try these tricks and ride the nausea out for about two weeks. In the majority of cases involving nausea from Zoloft, the side effect fades away as your body adjusts. Keep in mind that the positive effects of the medication take longer to appear.
In case the nausea hasn’t improved after 2 weeks or if you vomit more than two times, discuss changing or adjusting the medication with your psychiatrist or prescribing physician.
Last update: October 12, 2025
Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of disease or mental illness, seek immediate medical attention.