Can Sertraline Cause Night Sweats?
Yes, sertraline can definitely cause night sweats—sweating is a well-documented and common side effect of this medication, occurring in approximately 7-11% of patients taking sertraline across multiple clinical trials. 1
Evidence from FDA Drug Labeling
The FDA-approved prescribing information for sertraline explicitly lists "sweating increased" as one of the most common treatment-emergent adverse events in placebo-controlled trials 1:
- 8% of patients taking sertraline for major depressive disorder experienced increased sweating compared to 3% on placebo 1
- 6% of patients with OCD on sertraline reported increased sweating versus 1% on placebo 1
- 11% of patients with social anxiety disorder experienced increased sweating on sertraline compared to 2% on placebo 1
The FDA labeling also notes that sweating is among the typical side effects that can include "sweating, tremors, nervousness, insomnia or somnolence, dizziness, and various gastrointestinal and sexual disturbances" 2
Clinical Guideline Support
Multiple clinical guidelines confirm sweating as a recognized adverse effect of SSRIs as a class 2:
- The American Family Physician guidelines on managing depression note that diarrhea, dizziness, dry mouth, fatigue, headache, sexual dysfunction, sweating, tremor, and weight gain are commonly reported with second-generation antidepressants including sertraline 2
- Guidelines on premature ejaculation treatment describe the adverse event profile of SSRIs as typically including "nausea, dry mouth, drowsiness and reduced libido," with sweating specifically mentioned as part of serotonin syndrome in severe cases 2
Mechanism and Clinical Context
Sweating from sertraline occurs through serotonergic effects on central thermoregulation and autonomic nervous system function 3:
- The interaction between serotonergic and noradrenergic neurons in various brain regions determines the degree of sweating 3
- SSRIs can theoretically both initiate and inhibit sweating depending on the resulting noradrenergic "tone" 3
Clinical Studies in Elderly Patients
Research specifically examining sertraline in elderly patients (≥60 years) confirms sweating as one of the most frequently reported adverse events 4, 5:
- Sweating was among the top 10 most common adverse events in elderly patients receiving sertraline 50-150 mg/day 4, 5
- The tolerability profile regarding sweating is generally similar between younger and elderly patients 4, 5
Important Clinical Considerations
While sweating from sertraline is common and generally benign, it can occasionally be part of more serious conditions 2:
- Serotonin syndrome can present with sweating (diaphoresis) along with mental status changes, neuromuscular hyperactivity, and autonomic instability—this is a medical emergency 2
- Serotonin syndrome risk increases when sertraline is combined with other serotonergic medications (MAOIs, other SSRIs, tramadol, triptans, etc.) 2
- In mild cases of serotonin syndrome, symptoms include headache, nausea, sweating, and dizziness 2
Night sweats specifically should prompt evaluation for other potential causes 6:
- While medication-induced sweating (including from sertraline) is a common cause of night sweats, serious conditions like tuberculosis, lymphoma, HIV, and hyperthyroidism must be considered 6
- A thorough history and physical examination can help distinguish benign medication-related sweating from more concerning etiologies 6
Management Approach
If night sweats are bothersome but sertraline is otherwise effective, consider 2:
- Reassuring the patient that sweating is a known, common side effect that may diminish over time
- Practical measures like using lighter bedding, keeping the bedroom cool, and wearing moisture-wicking sleepwear
- If sweating persists and significantly impacts quality of life, discussing alternative antidepressants with your healthcare provider (though most SSRIs share this side effect) 2
Do not abruptly discontinue sertraline without medical supervision, as this can cause withdrawal symptoms 2, 1