How To Switch Zoloft (Sertraline) From Evening To Morning

In our latest question and answer, the pharmacist discusses how to change the time you take Zoloft (sertraline) from the evening to the morning.

Question

Hello, I have recently been prescribed Sertraline HCL 25MG and took the first dose last night around 10:30 pm. I found that I had a difficult time relaxing and couldn't get to sleep until 7:00 am which is abnormal because usually, I'm always tired. Now that I know that it won't make me drowsy. I want to switch to taking it in the mornings, but how do I do that safely? Is there a certain amount of time in which I should be taking them apart from each other? Thank you!

Asked by Switcharoo On Aug 07, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Aug 07, 2022
Last updated Aug 07, 2022

Key points

  • Sertraline is known to cause insomnia (reported at over 20% of patients experiencing it).
  • Switching to morning dosing may help alleviate insomnia.
  • Sertraline has a long half-life and adjusting the time you take your dose is relatively simple in most cases.
  • In some patients, it may be necessary to try another anti-depressant if the side effect of insomnia cannot be resolved or does not lessen on its own over time.

Thanks for reaching out to us! I'm more than happy to go through this situation. First, let's talk a little about what Zoloft is.

What Is Zoloft?

Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It is indicated for treatment in the following disorders:

  • Major depressive disorder
  • Obsessive-compulsive disorder
  • Post-traumatic stress disorder (PTSD)
  • Panic disorder Premenstrual dysphoric disorder (PMDD)
  • Social anxiety disorder

Side Effects Of Zoloft

Insomnia (20%) is more often reported in patients than is drowsiness (11%) or fatigue (12%) according to the package insert. Other common side effects include:

  • Nausea
  • Diarrhea
  • Drowsiness
  • Xerostomia (dry mouth)
  • Tremor
  • Dizziness
  • Decreased appetite
  • Decreased libido

In most cases, these side effects will decrease over time. However, some can linger, which may necessitate a change in how you take your medication or a change in medication entirely.

How To Change The Time You Take Zoloft (Sertraline)

With the approval of your doctor or other prescribing health care provider, switching sertraline to a morning dosing schedule (from the evening) could be helpful to mitigate some side effects, especially if you are experiencing insomnia.

One possible way to switch your dose from the evening to the morning is to simply skip the next scheduled evening dose and start taking sertraline again the next morning. While this will result in more than 24 hours elapsing between doses, Zoloft has a long half-life, over 24 hours in fact, and the drug will still be present in the body even though a dose has been skipped. It is very unlikely you'll experience any side effects from taking one dose a little later than usual.

This method is generally preferable to taking more than one dose in 24 hours, which puts you at a higher risk of side effects.

However, as mentioned above, you should speak with your doctor regarding the best way to change the administration time for your particular situation.

Sleep Hygiene Recommendations While Taking Zoloft (Sertraline)

Should insomnia continue to be a problem, good sleep habits should be followed. Some good sleep habits according to the CDC are:

  • Go to bed at the same time each night.
  • Make your bedroom a comfortable environment; cool, dark, and quiet.
  • Turn off all electronic devices including TV, phone, and computers.
  • Do not drink alcohol or caffeine before bedtime.
  • Exercise regularly. This can assist in falling asleep at night.

If insomnia is still an issue after putting good sleep habits in place, it is then time to discuss with your doctor or other health care provider other solutions, including a change in medication. Sometimes one medication may work better than another for a particular individual. There are plenty of options out there. Communication with your health care provider is key for treating the condition effectively and with minimal side effects.

References

  • Zoloft Prescribing Information, AccessFDA
  • Review of sertraline and its clinical applications in psychiatric disorders, PubMed
  • Sertraline: a review of its use in the management of major depressive disorder in elderly patients, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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