Zoloft (sertraline) is one of the most commonly prescribed antidepressants. If you’re taking it, it’s likely that you have a condition that sometimes causes insomnia—like anxiety or depression. On top of that, sleep disturbances may be a side effect of this type of medication. When you’re reaching for your morning dose of caffeine to wake up after a bad night’s sleep you may wonder: Is it safe to mix Zoloft and coffee? Or sertraline and caffeine for that matter?
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Caffeine and Zoloft side effects
Common side effects with Zoloft include dizziness, drowsiness, trouble sleeping, sexual problems, dry mouth, and possible digestive issues such as loss of appetite, upset stomach and/or diarrhea. More serious potential side effects include serotonin syndrome, suicidal thoughts and behaviors, seizures, and fast or irregular heart beat. Caffeine may intensify the severity of some symptoms, such as irregular heartbeat or difficulty sleeping, depending on how much is consumed.
Is it safe to mix Zoloft and coffee?
There are no known interactions between Zoloft and caffeine, but it’s important to consider the effects that caffeine can have on the mental health conditions that Zoloft treats.
“It should be safe to drink coffee with Zoloft,” says David Schaefer, MD, psychiatrist at Southwest Behavioral Health Center in St. George, Utah. “Caffeine and Zoloft are both metabolized by the liver’s CYP450 enzyme system, but via different enzymatic pathways.”
The bigger concern should be the effects that caffeine can have on depression and anxiety disorders. “Excessive caffeine use can be detrimental in the treatment of depression, anxiety, OCD, PTSD, etc.,” Dr. Schaefer says. The two main reasons are:
- Sleep disturbances: Zoloft and caffeine can both cause difficulty sleeping in some people. Sleep disturbances are also common with those suffering from depression and anxiety disorders. “Caffeine can compound the sleep deficits found in many patients with depression,” Dr. Schaefer says. “Insomnia is also a common symptom of anxiety disorders and decreased sleep has been shown to increase symptoms of anxiety.”
- Stimulants may increase anxiety: Those with anxiety disorders may want to avoid drinking a lot of coffee. “Because caffeine is a stimulant, it can increase symptoms of anxiety or over-alertness, whether related to panic disorder, social anxiety, or PTSD,” Dr. Schaefer explains.
Drinking coffee in moderation may help to mitigate any sleep disturbances or increased anxiety while taking Zoloft. But, there’s a fine line between feeling more alert during the day, and having too much caffeine. “Coffee has well-known side effects of causing insomnia and jitteriness in some people, and that is a dose-dependent effect,” says Robert G. Fawcett, MD, author of Calming the Bipolar Storm. “Six cups of java may cause a lot of jitteriness and insomnia, whereas one cup may not.”
On the flip side, Dr. Fawcett points out that people experiencing depression “without much anxiety, where a person feels slowed down, lethargic and sleeps excessively,” may actually benefit from some coffee. Most people prefer to drink coffee first thing in the morning, so the timing of your caffeine intake and the timing of your dosage may coincide.
Is it better to take Zoloft (sertraline) in the morning or at night?
Zoloft may be taken in the morning or evening, and it can be taken with or without food. It’s important to take it at a consistent time; and go over any concerns with your healthcare provider.
“Zoloft itself can be a bit stimulating for some folks, so I usually prescribed it to be taken in the morning,” Dr. Fawcett says. And Dr. Schaefer agrees: “I generally recommend patients take it in the morning because serotonin reuptake inhibitors can sometimes cause restless sleep and vivid dreams.”
Yet, for some people Zoloft may cause drowsiness. In this case it should be taken in the evening. “Occasionally, Zoloft can cause mild somnolence, in which case it can be switched to nighttime dosing,” Dr. Schaefer says.
When Zoloft is taken in the morning in conjunction with drinking coffee, there is some potential for digestive distress. “Both sertraline (Zoloft) and coffee might stimulate the bowel, so it is possible that taking them together a patient might experience enough diarrhea to necessitate stopping the coffee,” Dr. Fawcett says.
Because Zoloft may be taken in the morning or evening, a patient—along with the healthcare team—can decide what works best to mitigate any potential side effects.
What foods and drinks should be avoided when taking Zoloft?
It’s important to be aware of caffeine intake when taking Zoloft, but there are some other foods and drinks that could potentially interfere with the medication as well. These include:
- Alcohol: Alcohol can magnify the side effects of Zoloft including causing dizziness, drowsiness, and difficulty concentrating. It can also cause impairment.
- Grapefruit and grapefruit juice: Grapefruit can affect the absorption of many medications, including Zoloft. There is also an increased risk of side effects or toxicity from the sertraline when mixed with grapefruit juice.
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The most important thing to remember when taking Zoloft, or any other medication, is to go over any concerns involving food and drink interactions with your doctor. Drinking coffee in moderation may work for some patients taking Zoloft, but it’s good to be aware of how caffeine is affecting the health condition a patient is treating.