What are the side effects of Sertraline?

From the Guidelines

Sertraline is associated with several side effects, including gastrointestinal issues, sleep disturbances, and sexual dysfunction.

Common Side Effects

• The most commonly reported adverse events include:
  • Constipation
  • Diarrhea (higher rate compared to other SSRIs) 1
  • Dizziness
  • Headache
  • Insomnia
  • Nausea
  • Sexual adverse events
  • Somnolence

Severe Adverse Events

• Sexual Dysfunction: Sertraline has a higher rate of sexual adverse events compared to bupropion, but lower rates compared to paroxetine 1
• Suicidality: Although no evidence indicates an increase in the risk for suicide with SSRIs, the risk for nonfatal suicide attempts may be increased (odds ratio, 1.57 [CI, 0.99 to 2.55]) 1

Discontinuation Due to Side Effects

• Nausea and vomiting are the most common reasons for discontinuation in efficacy studies 1

From the FDA Drug Label

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:
  • Gastrointestinal: nausea, loss of appetite, diarrhea, indigestion
  • Sleep: change in sleep habits, increased sleepiness, insomnia
  • Sexual: decreased libido, ejaculation failure
  • Neurological: tremor, shaking, agitation
  • General: increased sweating, feeling tired or fatigued
• 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 2

From the Research

Side Effects of Sertraline

The side effects of sertraline are generally mild and transient, including:

• Gastrointestinal disturbances such as nausea and diarrhea/loose stools 3, 4
• Male sexual dysfunction, primarily ejaculatory disturbance 3, 4
• Dry mouth, headache, insomnia, somnolence, constipation, dizziness, sweating, and taste abnormalities in elderly patients 5
• Central nervous system effects 6
• Treatment-emergent sexual dysfunction 6

Comparison to Other Antidepressants

Sertraline has a wider safety margin and fewer side effects compared to tricyclic antidepressants, making it a better option for certain patient groups, such as the elderly 3, 4, 5. It also has a lower potential for drug interactions compared to other selective serotonin reuptake inhibitors (SSRIs) like paroxetine, fluoxetine, and fluvoxamine 5.

Special Considerations

Sertraline is generally well tolerated in elderly patients and lacks the marked anticholinergic effects that characterize the adverse event profiles of tricyclic antidepressants (TCAs) 5. It is also considered safe in overdose, with a favorable safety profile 6.