Is Zoloft 25 mg Too Small Of A Dose?

Our pharmacist answers the latest question regarding Zoloft 25 mg potentially being too small a dose to be effective.

Oct 02, 2017

Todd asked

Hello! 10 days ago I started taking Zoloft 25mg for my generalized anxiety disorder. I do not have any noticeable side effects except tiredeness.I am wondering: when the dosage is increased, do side effects usually appear? Also, can 25mg enough? I mean, I usually read about people taking 50mg and many of them say that 25mg is like a placebo...(I don’t know if dosage is related to weight, but I’m a 102 pounds) Thank you, have a nice day

Answer

Dosage for Zoloft is not based on weight, but weight can certainly be a factor. The dosage for antidepressants in general is based solely on clinical response to the drug at a given dose. Having said that, patients that have greater mass may need a higher dosage to see positive effects.

For Zoloft in particular, the usual effective dose is 50 mg. Below are the dosage recommendations that have been approved by the FDA:


​​For Treatment Of Major Depression:

50 mg PO once daily. A lower initial dose may be used (e.g., 25 mg) to minimize adverse effects. If necessary, increase at intervals of not less than one week up to 200 mg/day.


​​For Generalized Anxiety Disorder:

Initial dose of 25 mg PO once daily. After one week, increase dose to 50 mg PO once daily. If necessary, increase by 50 mg/day at intervals of not less than one week up to 200 mg/day.

25 mg, in my experience, typically is not very effective like you had mentioned in your question. I most commonly see people on 50 - 100 mg.Side effects do appear to be dose related meaning that higher doses do tend to produce more side effects. 

The most common side effects to higher doses of Zoloft are:

  • Nausea
  • Drowsiness/Fatigue
  • Sexual side effects (decreased libido/delayed orgasm)

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