Can I Increase My Dose of Sertraline Myself? Why You Should Always Ask Your Doctor First
Author:
Blossom Editorial
Feb 18, 2026
When you're taking sertraline (Zoloft) for depression or anxiety and not seeing the improvement you hoped for, you might wonder if increasing your dose on your own would help. This is a common question, and the answer is simple: increasing your dose without medical supervision isn’t recommended and can be unsafe.
Changing your dose is not about increasing the number of milligrams. Your doctor looks at several factors, such as how long you’ve been on the medication, how your symptoms are changing, whether you’re experiencing side effects, and what other medications you take. This information helps them determine the right dose adjustments for your individual situation.
Understanding why professional help matters can ensure that the treatment you’re receiving is safe, effective, and supportive of your overall well-being.
Key Takeaways
Dose changes for Sertraline should be made under medical supervision to ensure safety, the right timing, and to reduce the risk of side effects.Your doctor may consider multiple factors before changing doses, including how long you've been on the current dose, how your symptoms are improving, any side effects, and other medications you take.
If you feel your current dose isn't effective enough, discussing your concerns with a doctor can help determine whether a dose adjustment or another other treatment would work better.
Why Self-Adjusting Medications Is Risky
Usually, prescription medications like sertraline are adjustedunder a doctor's supervision. Changing your dose on your own can increase the risk of side effects, interaction with other medications, or other complications. Risk of Serotonin Syndrome
Serotonin syndrome is a rare but seriouscondition that happens whenyour serotonin levels become too high. The risk of serotonin syndrome increases when dose increments are too much or too quickor when sertraline is combined with other medications that also affect serotonin.
Symptoms of serotonin syndrome may include:
Severe restlessness or agitation
Confusion
Rapid heartbeat
High blood pressureuscle rigidity or twitching
Heavy sweating
Diarrhea
Headache
Shivering
In severe cases, high fever and seizures.
Because serotonin syndrome can become serious quickly, it’s advised to seek medical attention as the symptoms develop.
Increased Side Effects
Every medication has a dose range where it’s most effectivewhile keeping side effects manageable. According to FDA prescribing information, going above your prescribed dose can increase the risk and intensity of these side effects. Common side effects of sertraline that may become serious with higher doses include:
Severe nausea or vomiting
Extreme drowsiness or fatigue
Sexual side effects
Increased anxiety or agitation
Tremors or shakiness
Sleep problems
These side effects can affect your quality of life and might make you want to stop taking the medication entirely. However, stopping sertaline abruptly can lead to withdrawal symptoms, or even a return of depression or anxiety symptoms.
Risk of Withdrawal Later
If you increase your dose without telling your doctor and later need to reduce it, you might experience ‘withdrawal symptoms’. Sertraline withdrawal can lead to dizziness, nausea, headaches, irritability, insomnia, and strange sensations often described as "brain zaps."
While these symptoms are usually temporary, they can be uncomfortable. And when you change doses on your own, you're more likely to experience severe withdrawal symptoms. Your doctor typically reduces your dosegradually to minimize these symptoms.
What Your Doctor Considers Before Changing Your Dose
When you talk to your doctor about possibly increasing your sertraline, they evaluate several important factors before making any changes. This thorough approach ensures the adjustment is safe and likely to help alleviate your symptoms.
How Long You've Been on Your Current Dose
One of the first things your doctor considers is how long you've been taking your current dose. Sertraline typically takes 4-6 weeks to reach its full effect. If you haven't been on your current dose for several weeks, your doctor may recommend giving it more time before making any changes.
Antidepressants often need adequate time at a consistent dose to show their full benefit. In some cases, doctors can wait for at least 4-8 weeks at one dose before considering an increase.
Your Symptom Improvement
Your doctor may ask detailed questions about how you've been feeling since starting or adjusting your dose. This is to evaluate whetheryour symptoms have improved at all, stayed the same, or gotten worse. Even slight improvements may suggest that the medication is starting to work and might just need more time. If there has been no improvement after an adequate time, your doctor might recommenda dose adjustment or a different medication.
Theymay also ask about your specific symptoms like:
Sleep quality
Energy levels
Appetite
Ability to concentrate
Interest in activities
Anxiety levels
This detailed picture helps them understand whether a dose change would help.
Current Side Effects
Your doctor will also review anyside effects that you may beexperiencing on your current dose. If you're already having side effects, increasing the dose would likely make them worse. In that case, your doctor might suggest switching medications rather than increasing the dose.
If you're tolerating your current dose well, this may indicate there’s room to adjust the dose if clinically appropriate.
Other Medications and Health Conditions
Sertraline can interact with other medications and may affect people differently based on their health conditions. Your doctor will review your full medication list and health history before recommending a dose change.
For example, your doctor might be more cautious about dose increases or might recommend smaller increments if you:
Take blood thinners
Have liver problems
Take other medications that affect serotonin Your History with the Medication
If you've taken sertraline before and had a dose that worked well, your doctor considers this information. They may also ask youif you've had problems with medication changes in the past. This helps them determine if the dose adjustment is approproate for you and how to do it safely.
The Correct Way to Increase Sertraline
When your doctor determines that a dose increase is appropriate, they follow specific guidelines to adjust and monitor dose increments. This helps them ensure the safety and effectiveness of the adjusted dose, and how well you’re tolerating it.
Standard Dosing Guidelines
According to FDA prescribing information, for adults getting treatment for anxiety or depression, sertraline typically starts at 25 mg or 50mg per day, respectively. If an increase is needed and the medication is well tolerated, your doctor may increase it gradually. Dose adjustments are often made in 25 to 50 mg increments, with at least one week between changes. The maximum recommended dose for adults is 200 mg per day.
The timing between increases is also important. Doctors usually wait at least 1-2 weeks between dose increments to see how your body responds and to reduce the likelihood of side effects. Gradual changes are generally better tolerated than rapid increases.
Monitoring After Dose Changes
After a dose adjustment,, your doctor may schedule a followupwithin 1-2 weeks.This follow-up helps them evaluate how you're responding to the new dose and whether any side effects need attention.
During thisperiod, your doctor may look for:
Improvement in symptoms
Development or worsening of side effects
Any signs of serotonin syndrome
Your overall ability to function in daily life.
Regular check-ins ensure the new dose is safe and effective in alleviating symptoms and is well-tolerated.
What to Do If You Think You Need More Medication
If you're taking sertraline and feeling like it's not helping enough, there are safe and constructive next steps to consider:
Contact Your Doctor
Call your doctor's office to discuss your health concerns regarding the dose you’re currently taking. If you're struggling, you may not need to wait for your next scheduled appointment. Most doctors can schedule an earlyappointment or do a phone consultation to discuss medication adjustments.
It can be helpful to share:
How are you feeling
How long have you been on your current dose
What improvements have you noticed (if any)
What symptoms are still bothering you
Keep a Symptom Journal
Keeping a brief symptom log at least a week before your appointment can help your doctor understand your situation better and make informed decisions about treatment changes. You can track:
Mood changes
Energy levels
Sleep quality
Anxiety levels
Any side effects
Ask About All Options
When you talk to your doctor, ask about all available options, not just dose increases. Sometimes other approaches might work better, such as:
Adding therapy if you're not already doing it
Switching to a different antidepressant
Adding another medication to boost sertraline's effects
Making lifestyle changes that support mental health.
Your doctor can explain the potential benefits and risks of each option, so you can make a shared and informed decision about your health.
Be Honest About Side Effects
Sharing all side effects you're experiencing, even if they seem minor or embarrassing, is important. This is because these side effects can play an important role in determining whether a dose adjustment, medication change, or alternative strategy may be most appropriate.
For example, if you're having significant sexual side effects from your current dose, your doctor probably won't increase it—they'd more likely switch you to a different medication.
What About Missing Doses?
It’s a common practice that people try to make up for their missed doses by taking extra. Just as increasing the dose on your own isn’t recommended, you also shouldn't take extra. Here’s some guidance on how to handle missed doses safely:
If You Miss One Dose
If you forget to take sertraline, take it as soon as you remember—unless it's almost time for your next dose. In that case, skip the missed dose and take your next regular dose at the scheduled time. Avoid takingtwo doses at once to catch up.
If You Miss Multiple Doses
Missing several doses in a row can cause withdrawal symptoms and may reduce the effectiveness of your treatment.. If you've missed multiple doses, contact your doctor for guidance. They may suggest restarting at a lower dose and gradually increasing again, or they might give you different instructions based on how long you've been off the medication.
Getting Professional Support to Adjust Your Medication Safely
If you’re considering a dose adjustment or looking for guidance on your treatment options, professional help can make all the difference.
Blossom Health helps you connect with the board-certified psychiatrists who can assess your symptoms, current sertraline dose, treatment options, side effects, and recommend whether a dose increment is appropriate for you. With comprehensive care, careful monitoring, and evidence-based dose adjustments, your treatment can be both safe and effective.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you are experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
Sources
FDA. Zoloft (sertraline hydrochloride) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf
Mayo Clinic. (2026, February 01,).Sertraline (Oral Route). https://www.mayoclinic.org/drugs-supplements/sertraline-oral-route/description/drg-20065940
MedlinePlus. Sertraline. (2025, October 15). https://medlineplus.gov/druginfo/meds/a697048.html
National Alliance on Mental Illness. (2024, June). Sertraline (Zoloft). https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/sertraline-zoloft/
Cleveland Clinic. Sertraline Tablets. https://my.clevelandclinic.org/health/drugs/20089-sertraline-tablets
National Institute of Mental Health. (2023, December). Mental Health Medications. https://www.nimh.nih.gov/health/topics/mental-health-medications
Drugs.com. (2024, May 27). Sertraline Side Effects, Uses, and Dosage. https://www.drugs.com/sertraline.html
Medical News Today. (2023, February 28). Is my antidepressant dose too low? Signs, when to increase, and more. https://www.medicalnewstoday.com/articles/signs-your-antidepressant-dose-is-too-low
Healthline. (2025, July 18). Sertraline: Uses, Side effects, Dosage, Cost, and More. https://www.healthline.com/health/sertraline-oral-tablet
American Psychiatric Association. (2025) Practice Guidelines for the Treatment of Patients with Major Depressive Disorder. https://www.apa.org/depression-guideline
