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Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
If your mental health has seemed a little out of sorts for some time now, there’s a chance you’ve already spoken to a healthcare provider and been offered the common antidepressant sertraline. Whether you have been prescribed this antidepressant medication or are just curious, you might have some questions.
Sertraline is an FDA-approved medication that belongs to a class of drugs known as selective serotonin reuptake inhibitors, or SSRIs. Sertraline is approved to treat a variety of conditions, including depression and anxiety, and experts generally agree that it’s one of the most effective treatments on the market today.
So what’s the catch?
Like all SSRIs, sertraline (often prescribed under the brand name Zoloft) comes with side effects that you should be aware of before you start taking the medication.
Below, we’ve covered the common early side effects of taking sertraline, as well as the rarer, more serious side effects that you may encounter. We’ve also touched on the long-term side effect risk of sertraline.
You should know what to expect before taking any medication, so read on to prepare.
There are a lot of reasons you may take sertraline, a medication that can help you manage mental health disorders such as:
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)
Panic disorder or panic attacks
Social anxiety disorder (SAD)
Premenstrual dysphoric disorder (PMDD)
In some cases, it is also prescribed (but not FDA-approved) to treat acute bipolar disorder.
Regardless of why you’re taking sertraline, there’s a good chance you’ll encounter side effects in the first weeks.
Like other SSRIs, sertraline can cause a range of possible side effects that typically occur during the first few weeks of treatment, including:
Fatigue and tiredness
Weight gain or weight loss
Loss of appetite
We’ve shared more information on these common side effects below.
Does Zoloft make you tired? For many people, it certainly can.
It’s very common to feel a little low in energy during the first few weeks of taking sertraline, according to the National Alliance on Mental Illness. Fatigue and drowsiness are two of the most common side effects of sertraline, and if you’re using sertraline to treat depression, fatigue and tiredness can also be compounded by the effects of depression itself.
Dealing with fatigue and tiredness from sertraline can be a frustrating experience, but they usually pass over time. As the medication reaches a steady state in your body, you’ll generally start to notice a less pronounced effect on your energy levels.
But if you have persistent fatigue or drowsiness that doesn’t disappear within one month, it’s best to contact your healthcare provider.
Sertraline and other SSRIs can cause a variety of sexual side effects, from difficulty achieving orgasm to decreased sex drive.
According to a review of studies published in the journal The Mental Health Clinician, between 40 percent and 65 percent of people who take an SSRI experience some side effects related to sexual desire and performance. These side effects can affect both men and women.
In men, one of the most common side effects is difficulty achieving orgasm and ejaculating. Alongside ejaculation troubles, some men also experience a lower general level of interest in sex after using SSRIs such as sertraline, which may present as erectile dysfunction.
As for the Zoloft side effect in women, the most common sexual side effect of sertraline and other SSRIs is a lower level of interest in sex.
Like many other sertraline effects, 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.
But it’s worth noting the research did find that of the SSRIs, sertraline has one of the lower likelihoods of affecting sexual function. So if this side effect doesn’t go away, you may need to switch medication classes to something like tricyclic antidepressants, SNRIs or others.
Insomnia and a general reduction in sleep quality are both common side effects of SSRIs and other antidepressants. A 2017 review of research literature published in the journal Current Psychiatry Reports notes that it’s common for antidepressants to affect sleep (though it didn’t mention sertraline by name).
In particular, 17 percent of people using antidepressants experienced sleep disturbances compared to nine percent of people taking a placebo.
People who use sertraline may find that they have trouble sleeping, or find themselves waking up frequently throughout the night. As we mentioned before, sertraline can also cause you to be more sleepy than usual.
There are several ways to deal with sleep disturbances from sertraline. The best way is simply 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, so its concentration will be reduced by the time you sleep. And we know this sounds obvious, but you can help your chances of a good night’s rest if you avoid caffeine and other stimulants after noon.
In the long term, sertraline may actually help reduce levels of dizziness in people with chronic dizziness. Despite this, it’s not uncommon to feel dizzy during the first few weeks of using sertraline — potentially a result of lower blood pressure due to the medication (that does not mean that this is a treatment for high blood pressure, by the way).
Dizziness is a short-term side effect of sertraline that usually doesn’t persist for longer than two to four weeks, but if you notice that frequent dizziness or lightheadedness lasts for more than four weeks, contact your healthcare professional to discuss a lower dose of sertraline.
Sertraline and other SSRIs are associated with weight fluctuations, although not all people who take these medications will gain or lose weight.
Most of the weight gain caused by antidepressants is mild, with a 2017 study from Australia finding that high-dosage antidepressant users gain 0.28kg (about 0.6 lbs) per year on average.
In a 2018 UK study, researchers concluded that antidepressants may contribute to a long-term increased risk of weight gain. Another study published in the journal Nutrients found that antidepressant use is associated with a higher total calorie intake.
There’s also some research out there to suggest that — at least in the short term — sertraline may actually cause you to lose weight, especially if you’re diabetic. After all, one of the other side effects is a loss of appetite (which we’ll get to next).
This has been noted in studies as well. In one smaller study involving 33 patients with type 2 diabetes, researchers found that participants had decreases in overall weight, body mass index and waist circumference at the end of the 12-week observation period
If you’re concerned about weight gain or weight loss, talk to your healthcare provider.
Like other side effects of sertraline, reduced appetite is usually temporary and should wear off after the first few weeks on the medication.
The key to avoiding weight loss from sertraline is to monitor your food intake and maintain your pre-sertraline eating habits. 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.
Unfortunately, diarrhea is a common side effect of sertraline. In comparative studies of sertraline and other SSRIs, about 14 percent of people who were prescribed sertraline at a typical dose experienced diarrhea, compared to about seven percent of those on other SSRIs, according to an article published in the journal International Clinical Psychopharmacology.
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.
This side effect, like others, may often be managed by reducing your dosage of sertraline or switching to a different antidepressant, such as paroxetine or fluoxetine (Prozac), which are both less likely to cause diarrhea. If you have persistent diarrhea from sertraline, the best approach is to contact your healthcare provider.
The link between sertraline and headaches is a complicated one.
On one hand, headaches are a common side effect of the medication itself. These Zoloft headaches usually disappear after two to four weeks of use as the medication stabilizes in your body.
On the other hand, this SSRI has also been shown to be effective in treating chronic tension-type headaches, according to a study of 50 people.
It is important to discuss what medications you’re taking with your healthcare provider before you start on sertraline.
While some painkillers can interact with sertraline, it’s generally safe to take over-the-counter medications including Tylenol® if you experience headaches after starting sertraline. But be aware that in some cases, Tylenol may interact with sertraline as they both are metabolized through your liver.
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. If you have persistent or severe headaches from sertraline that don’t improve over time, talk to your healthcare provider.
While there’s no clear explanation for dry mouth, researchers believe that the effects of sertraline and other SSRIs on the brain can also affect your gastrointestinal system (one of the reasons some people occasionally report constipation or diarrhea).
According to the Food and Drug Administration, 14 percent of people prescribed antidepressants experience some level of dry mouth, compared to nine percent of people who take a placebo.
Dry mouth should go away on its own over the course of several weeks, but it’s also possible to reduce the severity of dry mouth by avoiding caffeine, alcohol, tobacco, spicy foods and other foods and drinks that can cause dehydration.
It is also recommended that you avoid using mouthwash products that contain alcohol, as they can make the problem worse.
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. Sugar-free gums can also help to stimulate saliva production and keep your mouth and throat properly hydrated.
Sertraline has been used since the 1990s by tens of millions of people, and in that time there have been no established side effects specific to long-term use.
That’s not to say that long-term side effects of Zoloft won’t ever be found. However, given the three-ish decades that the medication has been under close observation in patients, it gets less likely every year.
With tens of millions of prescriptions in the United States alone, sertraline is one of the most widely used SSRI medications on the market, so there are bound to be anecdotal issues with the medication, but they haven’t been seen in studies.
Still, iIf you see long-term effects as you continue taking sertraline, talk to a professional.
People who use sertraline may not experience any side effects at all, but it’s also possible for sertraline to cause potentially serious adverse effects for some users. It’s an unfair coin toss, but you should be aware of the warning signs of serious issues.
Some of the potential serious side effects of sertraline include:
Fainting and extreme dizziness
Needless to say, if you experience any of these side effects, or your side effects are worsening, you should contact your healthcare provider as soon as possible for medical assistance.
Read on for more details about what to watch out for.
According to the FDA, a small percentage of people who use sertraline may also experience severe dizziness and lightheadedness.
If you feel faint, weak or severely dizzy, or feel differences in your heart rate after taking sertraline, you should seek medical attention as soon as possible.
A small number of people who use sertraline have reported severe chest pain after taking the medication.
It’s important to point out that this side effect is very rare. Overall, sertraline is a safe and effective drug that’s widely used successfully, including by people with certain heart problems that make other SSRIs unsuitable. But if you experience severe or unusual chest pain after taking sertraline, you should seek medical help as soon as possible.
Sertraline is one of several SSRIs that may increase the risk of bleeding, according to an article published in the journal Pharmacological Research.
This means that while using sertraline, your body might have difficulty forming a normal blood clot if you cut or puncture your skin. You may notice that nosebleeds run a little longer, or that bruises are a little bigger.
Clotting issues from sertraline use can potentially occur as a result of taking sertraline together with other medications, such as blood thinners, so it’s essential that you inform your healthcare provider of any blood thinners before they prescribe sertraline.
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 young adults or adolescents who take antidepressant medications.
If you experience suicidal thoughts after you start using sertraline, seek medical assistance as soon as possible.
Seek immediate medical advice immediately if you experience an allergic reaction to sertraline.
Warning signs of an allergic reaction include hives, swollen face, sore throat and anaphylaxis, but it’s important to remember that even if these side effects seem particularly mild, they should be reported to a healthcare provider immediately for your safety.
If the above list of nightmare scenarios worries you, it’s important to remember that most people who use sertraline either experience no side effects at all or mild side effects that disappear as they become accustomed to the medication.
The vast majority of users are fine, safe and benefiting from this medication.
Still, there are some important takeaways to remember:
YES sertraline is safe and effective and typically only causes mild side effects.
BUT just because most people don’t experience problems doesn’t mean you won’t have adverse reactions yourself.
BEFORE you accept a prescription, make sure to tell your doctor about any health issues and other medications. You should not take sertraline if you have glaucoma, a history of heart problems or are breastfeeding.
BE AWARE that sertraline can potentially have drug interactions with a wide range of other medications, substances or supplements, like alcohol, monoamine oxidase inhibitors (MAOIs), nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and even St. John's Wort.
FYI: The use of sertraline with other SSRIs could lead to an increased risk of a life-threatening condition called serotonin syndrome, according to the book StatPearls. Our sertraline guide goes into more detail on sertraline interactions.
UNLESS you’re experiencing a serious side effect, do not stop taking sertraline without seeking medical advice. Abruptly stopping sertraline before your next dose could lead to serious withdrawal symptoms, including eye pain, nausea, headaches, irritability, nightmares or suicidal thoughts.
There’s much more to know. Read 25 more facts about sertraline here.
Sertraline will hopefully help you regain control over your mental health and day-to-day life and you’ll never see this list of side effects again. But if you’re worried or have further questions, talk to a professional.