From the Guidelines
Sertraline-induced diarrhea can be managed by taking the medication with food, using over-the-counter medications like loperamide, and making dietary modifications, but if it persists, consulting a healthcare provider for potential dosage adjustment or switching to a different antidepressant is crucial. According to the study by the American College of Physicians 1, sertraline has a higher rate of diarrhea compared to other SSRIs, which is a significant consideration for managing this side effect. The study highlights that most second-generation antidepressants have similar adverse events, but sertraline stands out with a higher incidence of diarrhea.
Some key points to consider for managing sertraline-induced diarrhea include:
- Taking sertraline with food to reduce gastrointestinal irritation
- Using over-the-counter medications like loperamide at standard dosing to manage symptoms temporarily
- Making dietary modifications such as avoiding spicy foods, caffeine, and high-fat meals, and increasing soluble fiber intake
- Staying well-hydrated to prevent dehydration
- Considering probiotics to help restore gut flora balance
It's essential to note that if diarrhea persists beyond 4 weeks or becomes severe, consulting a healthcare provider is necessary, as they may consider adjusting the sertraline dosage or switching to a different antidepressant 1. The healthcare provider's decision will be based on the individual patient's response to the medication and the severity of the side effect.
From the Research
Sertaline Induced Diarrhea
- Sertaline is an antidepressant that can cause gastrointestinal side effects, including diarrhea 2
- A systematic review and meta-analysis found that sertraline was one of the least tolerated antidepressants on the gastrointestinal tract, associated with all considered side effects except constipation and increased appetite 2
- The study included 304 studies and found that all considered antidepressants showed higher rates of gastrointestinal side effects than placebo 2
Management of Diarrhea
- There is no specific guidance on managing sertraline-induced diarrhea in the provided studies
- However, a patient-reported questionnaire (STIDAT) was developed and validated to assess systemic therapy-induced diarrhea in oncology patients, which may be relevant to managing diarrhea in general 3
- The STIDAT assesses patient's perception of having diarrhea, daily number of bowel movements, daily number of diarrhea episodes, antidiarrheal medication use, and other symptoms 3