How long does diarrhea typically last after starting sertraline (selective serotonin reuptake inhibitor)?

From the Guidelines

Diarrhea from sertraline typically lasts about 1-2 weeks as your body adjusts to the medication, though it can persist longer in some individuals. This side effect usually begins within the first few days of starting treatment or after increasing your dose, as noted in the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1. For most people, the digestive symptoms gradually improve as their body adapts to the medication. If diarrhea is severe or persists beyond 2-3 weeks, you should consult your healthcare provider. They might recommend taking sertraline with food, temporarily reducing the dose, or switching to a different SSRI. The diarrhea occurs because sertraline affects serotonin receptors in your gut as well as your brain, temporarily disrupting normal digestive function, which is a common side effect of SSRIs, including sertraline, as reported in a study on the assessment and treatment of children and adolescents with anxiety disorders 1. Staying hydrated is important while experiencing this side effect, and over-the-counter anti-diarrheal medications can be used for short-term relief if approved by your doctor. Remember that the therapeutic benefits of sertraline typically take 4-6 weeks to fully develop, so some temporary side effects are often worth enduring for the potential long-term benefits.

Some key points to consider when taking sertraline include:

• Starting with a low dose and gradually increasing it as needed and tolerated, to minimize the risk of adverse effects, such as diarrhea, as recommended in the clinical practice guideline 1.
• Monitoring for symptoms, especially in the first 24 to 48 hours after dosage changes, to quickly identify and address any potential issues, including serotonin syndrome, which can be triggered by combining serotonergic medications 1.
• Being aware of the potential for drug-drug interactions, particularly with other serotonergic agents, and taking steps to avoid them, as cautioned in the study on the assessment and treatment of children and adolescents with anxiety disorders 1.

Overall, while diarrhea can be an uncomfortable side effect of sertraline, it is usually temporary and can be managed with patience, hydration, and, if necessary, medical guidance.

From the Research

Duration of Diarrhea after Sertraline

• The duration of diarrhea after starting sertraline can vary, but there is limited direct evidence on this specific topic 2, 3, 4, 5, 6.
• According to a study on drug-induced diarrhea, diarrhea can be acute, lasting a few days, or chronic, lasting more than 3-4 weeks 2.
• Another study found that sertraline is generally well-tolerated, but common adverse effects include diarrhea, nausea, and vomiting 5.
• A systematic review and meta-analysis of gastrointestinal side effects associated with antidepressant treatments found that sertraline was one of the least tolerated antidepressants on the gastrointestinal tract, associated with diarrhea and other side effects 6.
• However, the exact duration of diarrhea after starting sertraline is not specified in these studies, and more research is needed to determine the typical duration of this side effect.

Factors Influencing Diarrhea Duration

• The duration of diarrhea may depend on individual factors, such as the dose of sertraline and the presence of other medical conditions 3, 4.
• A study on the clinical effectiveness of sertraline found that the drug was generally well-tolerated, but adverse events, including diarrhea, were reported in some patients 4.
• The study also found that the incidence of adverse events did not differ significantly between the sertraline and placebo groups 4.

Clinical Implications

• Clinicians should be aware of the potential for diarrhea and other gastrointestinal side effects when prescribing sertraline 6.
• Patients experiencing diarrhea or other adverse effects should be monitored closely and advised to report any changes in their symptoms 2, 5.
• Further research is needed to determine the optimal management of diarrhea and other side effects associated with sertraline treatment 6.