What are the side effects of Sertraline?

From the Guidelines

Sertraline can cause several side effects, including nausea, diarrhea, dizziness, headache, insomnia, and sexual dysfunction, as reported in a clinical practice guideline from the American College of Physicians 1. The most commonly reported adverse events associated with sertraline include:

• Constipation
• Diarrhea
• Dizziness
• Headache
• Insomnia
• Nausea
• Sexual adverse events
• Somnolence These side effects are often similar to those of other second-generation antidepressants, with some differences in the incidence of specific adverse events 1. Some severe adverse events associated with sertraline include:
• Sexual dysfunction, with sertraline having a higher rate of sexual adverse events than some other antidepressants, such as bupropion 1
• Suicidality, with some meta-analyses suggesting an increased risk of nonfatal suicide attempts associated with SSRIs, including sertraline 1 To minimize side effects, patients can take sertraline with food to reduce stomach upset, take it in the morning or evening depending on the side effect profile, stay hydrated, and maintain a balanced diet 1. It is essential to note that the incidence of specific adverse events can vary depending on the individual patient and the dose of sertraline prescribed, and patients should consult their healthcare provider if side effects persist or worsen 1.

From the FDA Drug Label

Sertraline may cause serious side effects, including: Feeling anxious or trouble sleeping Common possible side effects in people who take sertraline include: nausea, loss of appetite, diarrhea or indigestion change in sleep habits including increased sleepiness or insomnia increased sweating sexual problems including decreased libido and ejaculation failure tremor or shaking feeling tired or fatigued agitation Other side effects in children and adolescents include: abnormal increase in muscle movement or agitation nose bleed urinating more often urinary incontinence aggressive reaction heavy menstrual periods possible slowed growth rate and weight change.

The possible side effects of sertraline include:

• Serious side effects: feeling anxious or trouble sleeping
• Common side effects:
  • Gastrointestinal: nausea, loss of appetite, diarrhea, indigestion
  • Sleep: change in sleep habits, increased sleepiness, insomnia
  • Sexual: decreased libido, ejaculation failure
  • Neurological: tremor, shaking, agitation
  • General: increased sweating, feeling tired or fatigued
• Side effects in children and adolescents:
  • Abnormal increase in muscle movement or agitation
  • Nose bleed
  • Urinating more often
  • Urinary incontinence
  • Aggressive reaction
  • Heavy menstrual periods
  • Possible slowed growth rate and weight change 2 2

From the Research

Side Effects of Sertraline

The side effects of sertraline are varied and can be categorized into several groups.

• Gastrointestinal effects:
  • Nausea
  • Diarrhea/loose stools 3, 4
• Central nervous system effects:
  • Fatigue 5
  • Numbness 5
  • Hypermotoric behavior 6
  • Hypertalkativeness 6
  • Difficulty in falling asleep 6
  • Tremor 6
  • Blurred vision 6
• Sexual dysfunction:
  • Male sexual dysfunction (primarily ejaculatory disturbance) 3
  • Intermittent excessive delay of ejaculation 5
• Other effects:
  • Anticholinergic activity (minimal) 3
  • Cardiovascular effects (essentially devoid) 3

Special Considerations

Sertraline has been associated with behavioral activation in some patients, particularly adolescents 6. This can manifest as hypermotoric behavior, hypertalkativeness, and difficulty in falling asleep. The symptoms of behavioral activation appear to be dose-dependent, but the dose threshold varies widely among patients 6.

Comparison of Side Effects Across Studies

The side effects of sertraline have been compared across different studies, with some studies reporting similar side effects 3, 4 and others reporting additional side effects 5, 6. The study by 7 found that side effects increased with increasing dosage, but were usually mild and well tolerated.