Sertraline side effects are more likely in the first days and weeks of the therapy, both when starting it or increasing the dose. They can include nausea, diarrhea, headache, dizziness, sleep problems, sweating, fatigue, and sexual side effects.
It is a selective serotonin reuptake inhibitor (SSRI), which means its use causes the adjustment period and influences the functioning of digestion, sleep, sexual functions, and energy levels in the body.
What Side Effects Can Sertraline Cause?
Sertraline drug side effects vary from person to person – some might experience very few side effects, while others might have several of them upon starting the medication.
Common side effects include:
- Nausea
- Diarrhea or loose stools
- Headache
- Dizziness
- Dry mouth
- Fatigue
- Increased sweating
- Drowsiness
- Insomnia
- Restlessness
- Decreased sexual drive
- Delay in orgasm/ejaculation
Common Side Effects Within the First Weeks
There are certain effects that can develop within the first weeks of sertraline intake – they often concern digestion, nervous system, or sleep issues.
Nausea and diarrhea are common enough, as well as feeling shaky, nervous, agitated, or 'wired' in the first several days of the therapy.
On the other hand, some patients experience the opposite and feel excessively tired or sleepy.
These effects typically get better with time – the period of adaptation may take from several days to several weeks.
Because of this, doctors don't evaluate the efficiency of the drug within several days of the treatment.
How Long Do Sertraline Side Effects Typically Last?
In general, there are various sertraline side effects that can last for different amounts of time.
During the first few days
Digestive issues, headache, dizziness, sleeping issues, or mild restlessness may appear.
They do not necessarily mean that the medication won't work for you.
During the first 1-2 weeks
For many people, the symptoms like nausea, diarrhea, headache, or dizziness become more stable, while the body gets accustomed to the medication.
The effects related to sleep may take longer to stabilize.
After several weeks
Persistent symptoms need more attention if they interfere with your work, meals, sleep, sexual activity, or everyday actions.
Some of them, especially sexual, can be present as long as the therapy lasts.
Nausea and Stomach Related Issues
One of the most common sertraline side effects is nausea.
Serotonin doesn't influence only the brain, but also the digestive tract, so its modification may lead to:
- Nausea
- Diarrhea
- Loose stools
- Stomach irritation
- Decreased appetite
Regular intake of the medication might help the body adapt to it.
In general, sertraline can be taken both with and without food. In case of persistent nausea, you can ask a pharmacist or the prescribing physician whether taking it with food will help you.
Severe nausea, vomiting, diarrhea, dehydration, or other abdominal symptoms should be reviewed.
Sertraline and Sleep Related Effects
The medication can affect the sleep in various ways – some people feel sleepy after it, while others have insomnia or restlessness.
Therefore, the best time for taking the medication might depend on how it influences you.
In case you feel sleepy after taking it, you may prefer evening dosing, while those people who feel more awake might want to take it earlier in the day. Any change in the medication timing should meet the prescription.
Can Sertraline Cause Dizziness and Headache?
Yes. It may cause headaches and dizziness, particularly during the first adaptation period.
Both of these effects may improve with time.
In case of dizziness:
Rise slowly from the sitting position
Stay hydrated
Don't drive the car until you see how the medicine influences you
Be careful with stairs and any activity involving coordination
Persistent dizziness, fainting, severe headache, confusion, weakness should be evaluated.
Sexual Side Effects of Sertraline
Sexual effects belong to the group of sertraline side effects worth paying attention to.
The problems may include:
- Reduced sexual drive
- Delayed orgasm
- Difficulty in reaching orgasm
- Delayed ejaculation
- Erectile problems
These symptoms might be uncomfortable to speak about, but they represent medication issues and should be addressed.
Don't stop the medication immediately due to sexual side effects – talk to a healthcare provider about the dose, treatment, or alternative treatment.
Changes in Appetite and Weight
Sertraline may influence appetite in a different way – some patients have lower appetite in the first days of the therapy, while others experience its increase later.
So, the weight may decrease, stay stable, or increase.
Long-term weight changes are affected by many factors besides the medication – improvement of mood, physical activity, nutrition, sleep, and underlying conditions.
Can Sertraline Worsen Anxiety?
Yes. In the beginning, some people may experience increased nervousness, agitation, restlessness, or anxiety.
It seems surprising as sertraline was prescribed to fight it.
Mild activation effects may go away once the body adapts to the medication. But severe agitation, panic, worsening of mood, or inability to sit still should be reported to a healthcare professional.
Sertraline Side Effects After Increasing the Dose
Side effects which were absent previously may appear again in case of dose increase.
For example, a patient may experience:
- Nausea
- Headache
- Sleep disturbances
- Restlessness
- Dizziness
It happens as the body gets used to higher doses of the medication.
Changes in the dose should be done only according to the prescriber's instruction.
Serious Side Effects Requiring Medical Attention
While most side effects associated with sertraline are mild, some may require urgent medical intervention.
Contact a doctor in case of:
- Allergic reaction
- Seizures
- Severe confusion
- Unusual bleeding
- Signs of dangerously low sodium
- Mania symptoms
- Serotonin syndrome symptoms
Low sodium content may be indicated by headache, confusion, weakness, instability, or seizures.
Signs of Serotonin Syndrome
Serotonin syndrome is a rare condition, but it can be quite dangerous.
Its signs may include:
- High body temperature
- Agitation
- Confusion
- Fast heart rate
- Excessive sweating
- Muscle rigidity
- Muscle twitching
- Tremors
- Diarrhea
The risk of serotonin syndrome may be increased when sertraline is taken together with medications or substances increasing the level of serotonin.
In case of suspected serotonin syndrome, urgent medical evaluation is required.
Sertraline and Suicide Risks
Antidepressants have a special warning regarding the suicidal thoughts and behaviors, especially in children, adolescents, and young adults in the beginning of the therapy or after the dose increase.
Look for:
- Development of new suicidal thoughts
- Increased depression
- Severe agitation
- Unusual behavior changes
- Increased impulsiveness
- Suddenly worsening anxiety
Those who feel imminent danger should contact emergency service right away.
Sertraline and Bleeding Risk
Sertraline may increase the risks of bleeding because serotonin influences platelets.
The risk of it may be increased in case of taking:
- Aspirin
- NSAIDs (like ibuprofen and naproxen)
- Anticoagulants
- Any other drugs which affect bleeding
Contact a healthcare professional in case of bruising, frequent nosebleeds, vomiting blood, presence of blood in the stool, or black tarry stools.
What Happens When Stopping Sertraline Abruptly?
Abrupt termination of sertraline treatment may lead to discontinuation effects, such as:
- Dizziness
- Irritability
- Anxiety
- Nausea
- Flu-like symptoms
- Sleep disturbances
- Headache
- Unusual tingling or electric shock sensations
Usually, the medication is discontinued gradually.
The withdrawal schedule depends on the dose, course of the therapy, and the response of the body.
How to Handle Mild Side Effects of Sertraline?
Several tips may help to overcome side effects in the first days of the treatment:
- Take the medication regularly
- Stay hydrated
- Eat normally if possible
- Monitor sleep
- Don't change the dose independently
- Limit alcohol intake in case it increases dizziness or drowsiness
- Note the symptoms which interfere with everyday life
Patients taking sertraline 50 mg can have the same type of side effects which happen with other doses. Their intensity may vary and high doses don't influence all patients equally.
Frequently Asked Questions
Do Sertraline Side Effects Go Away?
The majority of the side effects disappear within the first few weeks of the treatment.
However, some of them, especially sexual ones, might persist and should be reported to a healthcare professional.
What Is the Most Common Side Effect of Sertraline?
There is no universal side effect which would be experienced by everybody. Nausea, diarrhea, sleep-related side effects, sweating, or sexual effects are typical ones.
Can Sertraline Make You Feel Bad Before Feeling Good?
Yes.
Nausea, anxiety, restlessness, sleep problems, or headaches may appear before the benefits of the antidepressant or anti-anxiety treatment will kick in.
How Long Does It Take for the Body to Adapt to Sertraline?
Approximately 2 to 4 weeks are needed for this adaptation period.
Does Sertraline Cause Sexual Side Effects?
Yes.
The effects which may occur include reduced libido, delay of orgasm, difficulties reaching orgasm, as well as ejaculation and erectile problems.
Should You Stop Sertraline in Case of Side Effects?
Minor side effects experienced in the beginning of the treatment don't necessarily require stopping the medication.
Serious, worsening, or persistent side effects should be discussed with a healthcare provider. Don't stop taking sertraline without the medical advice.
When Should You Consult a Physician or a Pharmacist?
Discuss any side effects which remain after adaptation period or get progressively worse, as well as side effects which interfere with working, eating, sleeping, relationships, or other activities.
Contact a professional immediately in case of severe agitation, unusual bleeding, confusion, seizures, mania, worsening suicidal thoughts, or any symptoms which may indicate serotonin syndrome.
Pharmacists at Grant Pharmacy can provide information about sertraline side effects in adults, the timing of the medication intake, possible interactions, and symptoms needing the consultation of the prescriber.
Medical References
U.S. Food and Drug Administration (FDA) – Zoloft (Sertraline Hydrochloride) Prescribing Information
https://www.accessdata.fda.gov/drugsatfda_docs/label/
U.S. National Library of Medicine, DailyMed – Sertraline Prescribing Information
https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=sertraline
National Health Service (NHS) – Sertraline
https://www.nhs.uk/medicines/sertraline/
MedlinePlus – Sertraline Drug Information
https://medlineplus.gov/druginfo/meds/a697048.html
U.S. Food and Drug Administration (FDA) – Antidepressant Medication Safety Information
https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/antidepressant-use-children-adolescents-and-adults
