The typical starting dose of sertraline is 50 mg once a day for most adults treating depression. For some conditions, the starting dose is lower at 25 mg per day, and the maximum for any condition is 200 mg per day. Your specific dose depends on what you’re treating, your age, and how you respond over time.
Starting Doses by Condition
Sertraline isn’t one-size-fits-all. The FDA-approved starting dose differs depending on the condition being treated:
- Depression: 50 mg once daily
- Obsessive-compulsive disorder (OCD): 50 mg once daily
- Panic disorder: 25 mg once daily
- PTSD: 25 mg once daily
- Social anxiety disorder: 25 mg once daily
- Premenstrual dysphoric disorder (PMDD): 50 mg once daily
The lower 25 mg starting point for panic disorder, PTSD, and social anxiety exists because people with these conditions can be more sensitive to initial side effects like jitteriness or increased anxiety. Starting lower gives the body time to adjust before moving up.
How Doses Get Adjusted Over Time
Most people don’t stay on their starting dose. If your symptoms haven’t improved enough, your prescriber will typically increase the dose in increments of 25 to 50 mg. The recommended minimum time between increases is one week, which matches how long it takes the drug to reach stable levels in your bloodstream. Sertraline has a half-life of about 26 hours, meaning it takes roughly a week of daily dosing for levels to fully stabilize.
Many people end up somewhere in the 50 to 150 mg range. For OCD specifically, effective doses tend to run higher. In clinical trials of children and adolescents with OCD, the average dose that worked was 178 mg per day, close to the ceiling. This pattern holds for adults with OCD too, where higher doses within the approved range are common.
The absolute maximum is 200 mg per day across all conditions and age groups.
PMDD Has a Unique Dosing Option
For premenstrual dysphoric disorder, sertraline can be taken in two different ways. The first is continuous dosing, where you take it every day throughout your cycle, starting at 50 mg and going up to 150 mg if needed. The second option is intermittent or “luteal phase” dosing, where you only take it during the roughly 14 days before your period starts, then stop when menstruation begins.
With intermittent dosing, the starting dose is 50 mg per day. If that’s not enough, the next cycle uses a stepped approach: 50 mg for the first three days of the dosing window, then 100 mg for the remaining days. The maximum with intermittent dosing is 100 mg, lower than the 150 mg ceiling for continuous use. Benefits for PMDD can appear as early as the first week of the first menstrual cycle after starting treatment.
Doses for Children and Older Adults
Sertraline is FDA-approved for OCD in children and adolescents ages 6 to 17. It is not approved for depression in this age group. The starting doses are split by age: children ages 6 to 12 begin at 25 mg per day, while adolescents ages 13 to 17 start at 50 mg. Increases happen in smaller increments for younger children (25 mg steps every few days) compared to teens (50 mg steps weekly), building up to a maximum of 200 mg per day as tolerated.
For older adults, the general principle is “start low, go slow.” Prescribers often begin with a quarter to half the usual adult starting dose, which means 12.5 to 25 mg per day. This cautious approach accounts for the way aging affects how the liver processes medications. The important nuance is that older adults still often need full therapeutic doses to get meaningful relief. The starting dose is lower, but the target dose may not be. Sertraline is considered one of the preferred antidepressants for older adults because of its relatively favorable side effect profile in this population.
How Long Before You Know It’s Working
Reaching the right dose is only part of the equation. Sertraline takes time to produce its full effect, and the timeline varies by condition. For depression, initial improvements in energy, sleep, and appetite often show up in the first one to two weeks. Full therapeutic effects typically take four to six weeks of consistent daily dosing.
OCD and PTSD generally take longer. You may need up to 12 weeks of continuous treatment before you can fairly judge whether sertraline is working at a given dose. This is one reason dose adjustments require patience. If your prescriber increases your dose, the clock partially resets, and it takes additional weeks to see the full impact of the change.
This timeline matters practically because it means the process of finding your right dose, from starting low to reaching an effective level, can take two to three months. Sticking with the medication through this window, even if improvements feel slow, is part of how sertraline is designed to work.
Why Your Dose Might Differ From Someone Else’s
Two people taking sertraline for the same condition can end up on very different doses. Someone with depression might do well at 50 mg, while another person needs 150 mg for the same level of relief. This isn’t a reflection of severity or willpower. Individual differences in how your liver metabolizes the drug, your body weight, genetic variations in serotonin-related pathways, and whether you take other medications all influence what dose works for you.
People with liver problems typically need lower doses or slower titration because the liver is responsible for breaking down sertraline. The drug’s active breakdown product lingers in the body much longer than sertraline itself, with a half-life of 62 to 104 hours, so impaired liver function can cause levels to build up more than expected.