Can sertraline (Selective Serotonin Reuptake Inhibitor) cause pancreatitis?

From the Guidelines

Sertraline can cause pancreatitis, although the causality has not been established, and it is recommended to discontinue the medication if pancreatitis is suspected. According to the most recent study 1, pancreatitis has been reported in clinical trials, highlighting the need for caution when prescribing sertraline. The study, published in 2025 in the journal Diabetes Care, emphasizes the importance of monitoring for potential gastrointestinal side effects, including pancreatitis, especially in individuals with kidney disease.

Key considerations when prescribing sertraline include:

• Monitoring for signs and symptoms of pancreatitis, such as severe upper abdominal pain, nausea, and vomiting
• Discontinuing the medication if pancreatitis is suspected
• Using caution in people with kidney disease due to the increased risk of gastrointestinal side effects and potential risk of acute kidney injury from dehydration
• Being aware of other potential safety concerns, including rare cases of severe liver injury and the risk of suicidal behavior/ideation in people younger than 24 years, as reported in the study 1

It is essential to weigh the benefits and risks of sertraline treatment and to consider alternative options if the patient has a history of pancreatitis or other risk factors. Healthcare providers should be vigilant in monitoring patients taking sertraline and promptly address any concerns or symptoms that may arise, as recommended in the study 1.

From the FDA Drug Label

rare reports of pancreatitis The FDA drug label for sertraline indicates that pancreatitis is a possible adverse event, although it is rare. This is supported by both 2 and 2, which mention pancreatitis as a potential risk associated with sertraline treatment.

• Key points:
  • Pancreatitis is a rare but potential side effect of sertraline.
  • The exact incidence of pancreatitis is not specified in the drug label.
  • Both labels 2 and 2 report pancreatitis as an adverse event.

From the Research

Sertraline and Pancreatitis

• Sertraline, a selective serotonin reuptake inhibitor (SSRI), has been associated with acute pancreatitis in several case reports and studies 3, 4, 5, 6, 7.
• The exact mechanism of sertraline-induced pancreatitis is not fully understood, but it is thought to be a rare side effect of the medication 3, 5.
• Studies have reported that the risk of acute pancreatitis is higher in patients taking SSRIs, including sertraline, particularly in cases of overdose or high doses 3, 6.
• A case-control study in Taiwan found that current use of SSRIs, including sertraline, was associated with an increased risk of acute pancreatitis, with an odds ratio of 1.7 (95% CI, 1.1-2.5) 6.
• Another study in Denmark found that the use of SSRIs, including sertraline, was associated with an increased risk of acute pancreatitis, with an adjusted odds ratio of 1.2 (95% CI, 1.0-1.5) for present users and 1.2 (95% CI, 0.9-1.7) for former users 7.

Clinical Implications

• Clinicians should be aware of the potential association between sertraline and acute pancreatitis, particularly in cases of overdose or high doses 3, 4, 5.
• Patients taking sertraline should be monitored for signs and symptoms of acute pancreatitis, such as abdominal pain, nausea, and vomiting 3, 5.
• If a patient develops acute pancreatitis while taking sertraline, the medication should be discontinued and the patient should receive conventional treatment for acute pancreatitis 3, 5.