Most Common Side Effects of Sertraline
The most common side effects of sertraline include nausea, diarrhea, dizziness, headache, insomnia, sexual adverse events (particularly ejaculatory dysfunction in males), and somnolence. 1, 2
Gastrointestinal Side Effects
- Nausea: One of the most frequently reported side effects and a common reason for discontinuation 1
- Diarrhea/loose stools: Sertraline has a higher rate of diarrhea compared to many other antidepressants including bupropion, citalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, and venlafaxine 1
- Loss of appetite: Commonly reported in patients taking sertraline 2
- Indigestion: May occur during treatment 2
Neurological Side Effects
- Headache: Among the most frequently reported adverse events (30-40% of patients) 3
- Dizziness: Common neurological side effect 1, 2
- Insomnia or changes in sleep habits: May include both increased sleepiness or difficulty sleeping 2
- Tremor or shaking: Can occur during treatment 2
- Increased sweating: Frequently reported 2
Sexual Side Effects
- Sexual dysfunction: Particularly common in males, primarily manifesting as ejaculatory delay or failure 2, 4
- Decreased libido: Can affect both men and women 2
- Sexual side effects are often underreported unless specifically asked about 5
- Sexual dysfunction is more frequent with sertraline compared to some other antidepressants like bupropion 3
Other Common Side Effects
- Fatigue: Feeling tired is commonly reported 2
- Agitation: Can occur in both adults and children 2
- Anxiety: May be experienced, particularly early in treatment 2
Special Considerations for Children and Adolescents
Additional side effects that may occur in children and adolescents include:
- Abnormal increase in muscle movement or agitation
- Nose bleeds
- Urinating more often
- Urinary incontinence
- Aggressive reactions
- Heavy menstrual periods
- Possible slowed growth rate and weight changes 2
Important Safety Considerations
While not among the most common side effects, patients should be aware of potentially serious adverse effects that require immediate medical attention:
- High fever
- Uncontrolled muscle spasms
- Stiff muscles
- Rapid changes in heart rate or blood pressure
- Confusion
- Loss of consciousness 2
Clinical Implications
- Nausea and vomiting are the most common reasons for discontinuation in clinical studies 1
- Most side effects are mild to moderate and often transient, decreasing in frequency with continued treatment 4
- Sertraline has minimal anticholinergic activity and is essentially devoid of cardiovascular effects, making it suitable for elderly patients or those with underlying cardiovascular disorders 4
- The safety margin of sertraline is wider than that of tricyclic antidepressants 6
Understanding these common side effects can help patients anticipate and manage them appropriately, potentially improving medication adherence and treatment outcomes.