Is sertraline (Zoloft) associated with dark urine, a potential indicator of impaired renal function or hepatic dysfunction?

From the Guidelines

Sertraline is not commonly associated with dark urine, but if you experience this side effect, you should promptly contact your healthcare provider to rule out potential liver problems or other serious issues. According to the study published in Gastroenterology 1, the focus is on the practical use of pharmacotherapy for obesity, and while sertraline is mentioned as a selective serotonin reuptake inhibitor (SSRI) that has been associated with weight loss with short-term use and weight neutrality with long-term use, there is no direct mention of dark urine as a side effect. However, it is essential to consider that dark urine can be a sign of dehydration or other underlying medical conditions.

If you are taking sertraline and notice dark urine, it is crucial to:

• Contact your healthcare provider promptly to discuss potential causes and necessary actions
• Ensure adequate hydration to rule out dehydration as a cause of dark urine
• Not stop taking sertraline abruptly without medical guidance to avoid withdrawal symptoms
• potentially undergo liver function tests to assess if sertraline is affecting your liver, as suggested by the general medical knowledge on SSRIs and their rare but potential side effects on the liver.

Your doctor may adjust your dosage or switch you to a different antidepressant if necessary, considering your individual circumstances and medical history. It is also important to note that many factors can cause dark urine, including certain foods, supplements, or medical conditions unrelated to your medication.

From the Research

Sertraline and Dark Urine

• Dark urine has been reported as a symptom in patients taking sertraline, particularly in cases of acute liver injury or hepatotoxicity 2.
• A case study published in 2013 reported a 26-year-old woman who presented with nausea, vomiting, malaise, and dark urine after taking sertraline for 6 months 2.
• The patient's liver biochemical profile demonstrated increased transaminases, and a liver biopsy showed lobular hepatitis, suggesting a drug-induced or toxin-induced etiology 2.
• The patient's liver function tests normalized after cessation of sertraline, indicating a probable association between sertraline use and acute hepatocellular injury 2.
• Other studies have also reported cases of sertraline-induced hepatotoxicity, although the exact mechanism is not fully understood 3, 4, 5.

Hepatotoxicity and Sertraline

• Sertraline has been associated with rare cases of hepatotoxicity, including elevated liver enzymes, jaundice, and gastrointestinal distress 3, 4, 5.
• The causal role of sertraline in liver failure has not been proven, but several case reports suggest a possible link between sertraline use and acute hepatocellular injury 3, 4, 5.
• Continuous monitoring for potential liver injury is recommended in patients treated with sertraline, particularly in vulnerable populations 5.

Relevance of Dark Urine

• Dark urine may be a symptom of underlying liver injury or hepatotoxicity in patients taking sertraline 2.
• Patients taking sertraline should be informed of the potential risks of hepatotoxicity and monitored regularly for signs of liver injury, including dark urine 3, 2, 4, 5.