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With tens of millions of prescriptions in the United States alone, sertraline is one of the most widely used SSRI medications on the market. Sertraline has been in use since the early 1990s. Safe and effective, it’s used by tens of millions of people every year without major side effects. However, like all SSRIs, sertraline side effects do exist, and you should be aware of them before you consider treatment.
Like other SSRIs, most sertraline side effects occur in the first few weeks of treatment and disappear over time. However, some can last for several months or occur at any time while using the medication.
Although rare, it’s possible to experience several more serious side effects if you use sertraline to treat depression, anxiety or any other condition.
Below, we’ve listed the common and uncommon side effects of sertraline. We’ve also linked to relevant studies and other data to provide some more context on how common or uncommon these side effects really are.
Common Sertraline Side Effects
Sertraline belongs to a class of medications known as selective serotonin reuptake inhibitors, or SSRIs. Like other SSRIs, it can cause a range of mild side effects that typically occur during the first few weeks of treatment. We’ve listed these common side effects below.
Fatigue and Tiredness
Fatigue and tiredness are two of the most common side effects of sertraline, as well as several other SSRIs.
If you’re using sertraline to treat depression, fatigue and tiredness from the medication can also be compounded by the effects of depression on your mood. It’s very common to feel a little low in energy during the first few weeks of taking sertraline.
While there’s no consensus on why this happens, researchers believe it could be triggered by the effects of SSRIs like sertraline on neurotransmitters such as acetylcholine.
Dealing with fatigue and tiredness from sertraline can be a frustrating experience, but it usually passes. As the medication reaches a steady state in your body, you’ll generally start to notice a less pronounced effect on your energy levels before this side effect fades completely.
If you have persistent fatigue or tiredness after starting sertraline that doesn’t disappear within one month, it’s best to contact your doctor.
Sexual Side Effects
Sertraline and other SSRIs can cause a variety of sexual side effects, from difficulty achieving orgrasm to a decreased libido and erectile dysfunction.
Sexual side effects are some of the most common side effects of sertraline and other commonly used SSRI medications. According to certain studies, between 40 and 65% of people who take SSRIs experience some side effects related to sexual desire and performance.
These side effects can affect both men and women. In men, the most common side effect is a higher level of difficulty achieving orgasm and ejaculating. Some men also experience a lower general level of interest in sex after using SSRIs such as sertraline.
In women, the most common sexual side effect of sertraline and other SSRIs is a lower level of interest in sex.
Like many other side effects of sertraline, sexual side effects can often fade over time as your body gets used to the medication. If persistent, sexual side effects can be treated by adjusting your dosage or switching to a different medication.
Insomnia and a general reduction in sleep quality are both common side effects of SSRIs and other antidepressants. Many people who use sertraline find it more difficult than normal to fall asleep, or find themselves waking up frequently throughout the night.
While it doesn’t list the effects of sertraline specifically, a 2017 study notes that it’s common for antidepressants to affect sleep. Like many other SSRI side effects, the study states that these effects are most common in the short term.
There are several ways to deal with insomnia from sertraline. The first is to wait it out, as this side effect tends to fade away as the medication reaches a steady state in your body. It’s also possible to take sertraline in the morning to reduce its concentration by the time you sleep.
Finally, it’s important to avoid caffeine and other stimulants that could prevent you from falling asleep in a normal amount of time. Try to restrict your consumption of coffee, caffeinated soda and energy drinks to before noon to avoid them affecting you when it’s time to fall asleep.
It’s not uncommon to feel dizzy during the first few weeks of using sertraline. Like other common side effects, this is thought to be a result of your body adjusting to the medication. Dizziness is a short-term side effect of sertraline that usually doesn’t persist for longer than two to four weeks.
Interestingly, sertraline is linked to lower levels of dizziness in the long term in studies, indicating that it could help you feel less dizzy once the medication reaches a steady state in your body.
If you notice frequent dizziness or lightheadedness after using sertraline that lasts for more than four weeks, it’s important to contact your doctor. This side effect can often be treated by using a lower dose of the medication or by taking sertraline at night, rather than in the daytime.
Sertraline and other SSRIs are associated with weight gain, although not all people who take these medications will gain weight.
Around 25% of people who use antidepressants gain weight while on their medication. Most of the weight gain caused by antidepressants is mild, with a 2017 study from Australia finding that, on average, high-dosage antidepressant users gain 0.28kg (about 0.6lbs) per year.
In a 2018 UK study, researchers concluded that antidepressants may contribute to a long-term increased risk of weight gain. Another study found that antidepressant use is associated with a higher total calorie intake.
Unlike other medications, SSRIs like sertraline don’t appear to have a direct effect your body’s metabolism. However, over the long term, they could affect your appetite, causing you to eat a larger amount of food that can contribute to an increase in body mass.
If you’re concerned about weight gain from sertraline, it’s best to talk to your doctor. Most of the time, you can avoid changes in your body mass and composition by monitoring your food intake and maintaining your pre-treatment eating habits while using sertraline.
This might sound unbelievable after the side effect listed above, but sertraline could potentially cause you to have a reduced appetite.
Like other side effects of sertraline, this is usually temporary. Many people prescribed sertraline feel less hungry during the first few weeks of treatment before noticing a stronger appetite over the long term.
Just like with weight gain, the key to avoiding weight loss from sertraline is to talk to your doctor and monitor your food intake. By staying consistent with your eating habits and activity level, it’s easier to maintain your body mass and composition while using sertraline or any other SSRI.
Diarrhea is a common side effect of sertraline. In studies of sertraline and other SSRIs, about 14 to 16% of people who are prescribed sertraline at a typical dose will experience diarrhea during the course of treatment.
Like many other side effects, diarrhea usually occurs in the first few weeks of treatment. Most of the time, diarrhea becomes less frequent and disappears completely as your body adjusts to the medication and your dosage of sertraline reaches a steady state.
If you have persistent diarrhea from sertraline, the best approach is to contact your doctor. This side effect can often be treated by reducing your dosage of sertraline or switching to a different antidepressant, such as paroxetine or fluoxetine, which are both less likely to cause diarrhea.
It’s common to experience headaches after you start using sertraline, particularly in the first few weeks of treatment. Like other common side effects, headaches usually disappear after two to four weeks of use as the medication reaches a steady state in your body.
While some painkiller can interact with sertraline, it’s safe to take paracetamol if you experience headaches after starting sertraline.
If you have persistent or severe headaches from sertraline that don’t improve over time, it’s best to talk to your doctor. Simple changes to your sertraline usage such as taking your medication at a different time of day or reducing your dosage can help to limit or get rid of headaches.
Finally, dry mouth is a common side effect of sertraline and other antidepressants. While there’s no clear reason for this, researchers believe that the effects of sertraline and other SSRIs on the brain can also affect your gastrointestinal system.
Studies show that between 35% and 46% of people prescribed antidepressants experience some level of dry mouth. Although sertraline is slightly less likely to cause dry mouth than other drugs in this category (in trials, it affects about 16% of people), it’s still fairly common.
There are several ways to treat dry mouth from sertraline. Like other side effects, dry mouth is often temporary, meaning it should go away on its own over the course of several weeks as the medication reaches a steady state in your body.
It’s also possible to reduce the severity of dry mouth by avoiding caffeine, alcohol, tobacco, any spicy foods and other substances that can cause dehydration. Sugar-free gums can also help to stimulate saliva production and keep your mouth and throat properly hydrated.
Finally, if you have persistent dry mouth from sertraline, you should talk to your doctor. Just like many other side effects of sertraline, dry mouth can often be avoided by adjusting your dosage or switching to a different SSRI medication.
Serious Side Effects of Sertraline
Most people who use sertraline won’t experience any side effects, or will only experience a few of the mild side effects listed above. However, it’s also possible for sertraline to cause a variety of potentially serious effects in some users.
Below, we’ve listed the serious potential side effects of sertraline. If you experience any of these side effects, you should contact your doctor as soon as possible for medical assistance.
Fainting and Extreme Dizziness
Although it’s very rare, fainting is a potential side effect of sertraline. A very small percentage of people who use sertraline also experience severe dizziness and lightheadedness, often shortly after taking the medication.
If you feel faint, weak or severely dizzy after taking sertraline, you should seek medical help as soon as possible.
A small number of people who use sertraline have reported severe chest pain after taking the medication.
In one study, an elderly woman experienced severe, crushing chest pain after taking a normal dose of sertraline. The woman was hospitalized and received treatment using a range of drugs used to treat heart conditions.
If you experience severe or unusual chest pain after taking sertraline, you should seek medical help as soon as possible.
It’s important to point out that this side effect is extremely rare. Overall, sertraline is a safe and effective drug that’s widely used successfully, including by people with certain heart conditions that make other SSRIs unsuitable.
Sertraline is one of several SSRIs that can act as a blood thinner, meaning it could affect your body’s ability to from blood clots. This means that if you injure yourself in a way that results in bleeding while using sertraline, your body might have difficulty forming a normal blood clot.
Clotting issues from sertraline use are rare and can potentially occur as a result of interactions with other medications, such as blood thinners. If you use other medications that could affect your clotting ability, it’s essential that you inform your doctor before considering sertraline.
Sertraline and other antidepressants have the potential to cause priapism, a condition that can result in a long-lasting, painful erection. Priapism can cause the penis to stay erect for hours at a time, resulting in severe discomfort and potentially causing damage to penile tissue.
Priapism is a very rare side effect of sertraline and other SSRIs. If you experience a persistent, painful erection after taking sertraline or any other antidepressant, you should seek immediate medical assistance.
Sertraline and several other widely used antidepressants can increase your risk of experiencing suicidal thoughts. The risk of suicidal thoughts appears to be the highest in people aged under 25 who take antidepressants to treat non-depression conditions such as anxiety.
Despite this, a meta-analysis of studies of SSRIs such as sertraline found that SSRIs do not cause any measurable increase in suicide rates. There’s also only weak evidence of increases in self-harm among people who use SSRIs.
If you experience suicidal thoughts after you start using sertraline, it’s important to seek medical assistance as soon as possible.
Learn More About Sertraline
While many of the side effects listed above can look alarming, it’s worth remembering that most people who use sertraline either experience no side effects at all, or light, transient side effects that disappear as they become accustomed to the medication.
Sertraline is one of the most common, widely used antidepressants in the world, with more than 37 million prescriptions in the US alone. For the vast majority of users, it’s a safe, effective and important medication that provides real benefits.
In addition to the side effects listed above, sertraline can potentially interact with a wide range of other medications and substances, including alcohol. Our 101 guide to sertraline goes into more detail on these interactions, as well the essentials of how sertraline works as a medication.