Can You Take Sertraline with Zopiclone?

Severity assessment

Moderate. Concomitant use of sertraline and zopiclone can lead to additive central nervous system (CNS) depression, increasing the risk of excessive sedation, respiratory depression, and impaired psychomotor function.

Mechanism (plain English)

Sertraline is an antidepressant that works by increasing the levels of a natural brain chemical called serotonin. Zopiclone is a sedative-hypnotic medication that works by enhancing the activity of another brain chemical called gamma-aminobutyric acid (GABA), which calms brain activity. When these two medications are taken together, their individual calming effects on the brain can combine, leading to a stronger-than-expected sedative effect. This additive effect can slow down brain function, affecting alertness, coordination, and breathing.

Evidence level

Regulator-flagged. The interaction is noted in product information from the Therapeutic Goods Administration (TGA) [1] and the British National Formulary (BNF) [2], and is classified as a moderate interaction by Drugs.com [3] which references UK and Australian product information.

Top regulator advisories (cite verbatim or close paraphrase)

• TGA (Australia): The Australian Product Information for Imovane (zopiclone) states that "Additive CNS depressant effects should be expected if zopiclone is administered concomitantly with other medications which themselves produce CNS depression, for example... other antidepressants" [1]. No pair-specific public advisory for sertraline + zopiclone was found, but the applicable product information for zopiclone warns against co-administration with other CNS depressants, including antidepressants.
• MHRA / NICE (UK): The British National Formulary (BNF) for zopiclone advises that "Additive CNS depressant effects should be expected if zopiclone is administered concomitantly with other medications which themselves produce CNS depression, for example... other antidepressants" [2]. The MHRA has also issued advice on strengthening warnings regarding addiction, dependence, withdrawal, and tolerance for Z-drugs [2].
• FDA / CDC (US): The FDA label for Zoloft (sertraline) lists "Other Serotonergic Drugs" as increasing the risk of serotonin syndrome, but does not specifically mention zopiclone or other non-benzodiazepine hypnotics in the context of additive CNS depression [4]. However, the FDA label for sertraline does warn about concomitant use with other CNS depressants in general terms within the context of alcohol interaction [4]. No specific FDA advisory for sertraline + zopiclone was found.
• EMA (Europe): No specific EMA advisory for sertraline + zopiclone was found in the researched documents.

Clinical risk factors that elevate the danger

Elderly patients are at increased risk due to potentially reduced metabolism and increased sensitivity to CNS depressant effects. Patients with pre-existing respiratory conditions (e.g., chronic pulmonary insufficiency, sleep apnoea) are at higher risk of respiratory depression. Individuals with a history of alcohol or drug abuse may have an increased risk of dependence and abuse. Patients with hepatic impairment may experience reduced clearance of zopiclone, leading to increased plasma concentrations and enhanced effects. Concomitant use of other CNS depressants, including alcohol, opioids, benzodiazepines, or other sedatives, significantly increases the risk of adverse effects.

What a patient should be told

• Taking sertraline and zopiclone together can make you feel excessively sleepy, dizzy, or confused, and can slow down your breathing. This is because both medications have a calming effect on your brain, and when combined, these effects can become too strong.
• Do not stop taking either medication suddenly without talking to your doctor or pharmacist first. Stopping abruptly can lead to withdrawal symptoms or a worsening of your original condition.
• Be aware of warning signs such as extreme drowsiness, difficulty waking up, slow or shallow breathing, unusual confusion, or feeling lightheaded. If you experience any of these, seek medical attention immediately.
• Discuss with your doctor or pharmacist if there are alternative treatments or strategies to manage your sleep difficulties that might be safer when you are taking sertraline.
• If you or someone you know experiences severe difficulty breathing, unresponsiveness, or extreme confusion after taking these medications, call for urgent medical help (e.g., 911 in the US, 000 in Australia, 999 in the UK) right away.

Top 3 sources (with full citation)

1. Sanofi-Aventis Australia Pty Ltd. Imovane (Zopiclone) Film Coated Tablet Product Information. medsinfo.com.au. Available at: https://medsinfo.com.au/api/documents/Imovane_PI?format=pdf (Accessed: June 1, 2026).
2. NICE. Zopiclone | Drugs - BNF. bnf.nice.org.uk. Available at: https://bnf.nice.org.uk/drugs/zopiclone/ (Accessed: June 1, 2026).
3. Drugs.com. Interactions between Eszopiclone and Zoloft. drugs.com. Available at: https://www.drugs.com/drug-interactions/eszopiclone-with-zoloft-1030-0-2057-1348.html?professional=1 (Accessed: June 1, 2026).

Notes for the reviewing pharmacist

While the FDA label for sertraline does not explicitly name zopiclone, it broadly warns about additive CNS depressant effects with other serotonergic drugs and alcohol. The BNF and Australian PI for zopiclone provide more direct warnings regarding co-administration with other antidepressants due to additive CNS depression. The interaction is primarily pharmacodynamic, leading to enhanced sedative and respiratory depressant effects. Although eszopiclone (the S-enantiomer of zopiclone) is mentioned in some sources, the clinical implications for racemic zopiclone are considered similar. Pharmacists should emphasize patient education on CNS depressant symptoms and the importance of avoiding alcohol. Consideration should be given to dose adjustments and careful monitoring, especially in vulnerable populations such as the elderly or those with respiratory compromise. The risk of dependence and withdrawal with Z-drugs should also be reinforced.

Source metadata JSON

{
  "pair": "sertraline + zopiclone",
  "severity": "Moderate",
  "evidence_level": "Regulator-flagged",
  "source_urls": "https://medsinfo.com.au/api/documents/Imovane_PI?format=pdf;https://bnf.nice.org.uk/drugs/zopiclone/;https://www.drugs.com/drug-interactions/eszopiclone-with-zoloft-1030-0-2057-1348.html?professional=1"
}