From the Guidelines
Sertraline can cause several side effects, including common effects like nausea, diarrhea, and sexual dysfunction, as well as more serious but less common effects like serotonin syndrome and increased risk of suicidal thoughts, particularly in young adults and adolescents during the initial treatment period. The most commonly reported adverse events associated with sertraline include constipation, diarrhea, dizziness, headache, insomnia, nausea, sexual adverse events, and somnolence 1.
Common Side Effects
- Nausea
- Diarrhea
- Dizziness
- Headache
- Insomnia
- Sexual dysfunction These side effects are typically mild and often improve within the first few weeks of treatment as the body adjusts to the medication.
Serious Side Effects
- Serotonin syndrome
- Increased risk of bleeding
- Hyponatremia
- Suicidal thoughts It is essential for patients to be closely monitored by their healthcare provider, especially during the initial treatment period, to assess for these potential side effects and adjust treatment as necessary 1.
Monitoring and Treatment Adjustment
Regular assessment of patient status, therapeutic response, and adverse effects of antidepressant therapy is crucial, beginning within 1 to 2 weeks of initiation of therapy 1. If a patient does not have an adequate response to pharmacotherapy within 6 to 8 weeks, treatment should be modified 1. Patients should be aware of the potential for withdrawal symptoms if the medication is stopped abruptly and should taper under medical supervision if discontinuation is necessary. Overall, while sertraline can be an effective treatment for depression, patients and healthcare providers must be aware of the potential side effects and take steps to monitor and manage them appropriately.
From the FDA Drug Label
What are the possible side effects of sertraline? 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:
- nausea
- loss of appetite
- diarrhea or indigestion
- change in sleep habits
- increased sweating
- sexual problems
- tremor or shaking
- feeling tired or fatigued
- agitation
- 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 Additionally, other side effects of sertraline may include:
- Psychiatric disorders: yawning, other male sexual dysfunction, depression, amnesia, teeth-grinding, emotional lability, apathy, abnormal dreams, euphoria, paranoid reaction, hallucination, aggressive reaction, delusions 2
- Reproductive disorders: menstrual disorder, dysmenorrhea, intermenstrual bleeding, vaginal hemorrhage, amenorrhea, leukorrhea 2
- Respiratory system disorders: rhinitis, coughing, dyspnea, upper respiratory tract infection, epistaxis, bronchospasm, sinusitis 2
- Special senses: tinnitus, conjunctivitis, earache, eye pain, abnormal accommodation 2
- Urinary system disorders: micturition frequency, polyuria, urinary retention, dysuria, nocturia, urinary incontinence 2
- Laboratory tests: asymptomatic elevations in serum transaminases, small mean increases in total cholesterol and triglycerides, and a small mean decrease in serum uric acid 2
From the Research
Side Effects of Sertraline
The side effects of sertraline (Zoloft) have been documented in several studies 3, 4, 5, 6, 7. Some of the common side effects include:
- Gastrointestinal disturbances such as nausea, diarrhea, and loose stools
- Male sexual dysfunction, primarily ejaculatory disturbance
- Central nervous system effects such as headache, insomnia, somnolence, and dizziness
- Treatment-emergent sexual dysfunction
- Withdrawal reactions associated with abrupt discontinuation of the agent
Severity and Duration of Side Effects
The severity and duration of these side effects can vary, but they are usually mild and transient, decreasing in frequency with continued treatment 3, 4. In some cases, the side effects may be more pronounced, such as dry mouth, constipation, sweating, and taste abnormalities, particularly in elderly patients 6.
Comparison with Other Antidepressants
Compared to other antidepressants, sertraline has a more favorable side effect profile, with minimal anticholinergic activity, no significant cardiovascular effects, and a wide therapeutic index 3, 4. This makes it a suitable option for patients with underlying cardiovascular disorders or those who are elderly.
Special Considerations
It's worth noting that sertraline has a low potential for drug interactions at the level of the cytochrome P450 enzyme system, which is an advantage in patient groups such as the elderly who are likely to receive multiple drug regimens 6. Additionally, sertraline has been shown to be effective and well-tolerated in patients with major depressive disorder, including those with vascular morbidity, diabetes mellitus, or arthritis 6.