Sertraline Side Effects: Common, Severe & Long-Term

If your mental health has felt out of sorts for a while now, there’s a chance you’ve already spoken to a healthcare provider about the common antidepressant sertraline (often sold under the brand name Zoloft^®). Whether you’ve been prescribed this antidepressant medication or you’re just curious about it, you might be wondering what it is, exactly,  and its potential side effects.

Sertraline is an FDA-approved medication that belongs to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs. 

It’s approved to treat a variety of conditions, including major depressive disorder and some anxiety disorders, like panic disorder or panic attacks, social anxiety disorder, and obsessive-compulsive disorder (OCD). It’s also one of the only SSRIs approved to treat post-traumatic stress disorder (PTSD) and premenstrual dysphoric disorder (PMDD).

Like all SSRIs, sertraline comes with side effects that you should be aware of before you start taking the medication.

Below, we’ve covered the common early side effects of taking sertraline, as well as the rarer, more serious side effects that you may encounter. We’ve also touched on the long-term side effect risk of sertraline.

Regardless of why you’re taking sertraline — like other SSRIs — there’s a chance you might encounter some side effects during the first few weeks of use while your body adjusts to the medication.

Some common side effects include:

• Nausea

• Fatigue and tiredness

• Sexual problems, specifically decreased desire and difficulty reaching orgasm

• Sleep disturbances

• Dizziness

• Weight gain or weight loss

• Loss of appetite

• Diarrhea

• Headaches

• Dry mouth

We’ll explore each of these common side effects in more detail below.

Nausea

If you’re nauseous while taking sertraline, you’re not alone. About one in four people experience this side effect.

The good news is that you’re most likely to experience nausea in the first week or two of taking sertraline while your body adjusts. After that, nausea usually goes away on its own.

In the meantime, taking your sertraline dose with bland foods or ginger tea may help alleviate any nausea. For most people, the nausea is manageable, similar to how you might feel after a bumpy plane ride. Occasionally, though, it can be more severe and lead to vomiting.

Keep in mind that it’s also possible to experience nausea if you abruptly stop taking sertraline, as your body may go through withdrawal symptoms. If you want to stop taking sertraline, talk to your doctor about a timeline for tapering your dosage to avoid nausea and other side effects.

Fatigue and Tiredness

Does Zoloft make you tired? It can.

Fatigue and drowsiness are two of the most common side effects of sertraline, so it’s normal to feel a little low in energy during the first few weeks of taking it.

These side effects can be frustrating, but you’ll generally start to notice a less pronounced effect on your energy levels as the medication reaches a steady state in your body.

If you have persistent fatigue or drowsiness that doesn’t disappear within one month, it’s best to contact your healthcare provider.

It’s worth noting that fatigue and tiredness are also symptoms of depression. As sertraline starts to work, you may notice a boost in your energy.

Sexual Problems

Sertraline and other SSRIs can cause a variety of sexual side effects, including: 

• Difficulty achieving orgasm 

• Decreased sex drive

• Erectile dysfunction 

• Delayed lubrication

According to a review of studies, between 40 percent and 65 percent of both men and women who take an SSRI experience some side effects related to sexual desire and performance.

In men, one of the most common side effects is difficulty achieving orgasm and ejaculating. Some men also experience a lower general level of interest in sex after using SSRIs such as sertraline, which may present as erectile dysfunction.

As for the Zoloft side effects in women, the most common sexual side effect of sertraline and other SSRIs is a lower level of interest in sex and difficulty reaching orgasm. Some women also report delayed lubrication. 

Sexual side effects may fade over time as your body gets used to the medication, but they usually linger. If persistent, sexual side effects can be treated by adjusting your dosage, adding a second medication, like bupropion, which often does a good job of restoring normal sexual functioning, or switching to a different medication with a healthcare provider’s guidance.

It’s worth noting the research did find that of the SSRIs, sertraline has one of the lower likelihoods of affecting sexual function. So if this side effect doesn’t go away, you may want to consider switching medication classes to something like tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs), or bupropion (Wellbutrin^®).

Additionally, diminished interest in sex can be a symptom of depression. As treatment progresses and your depression eases, you may notice your sex drive improving and returning to its usual baseline.

If you experience sexual side effects while taking sertraline, it’s a good idea to discuss it with your partner. Otherwise, they may mistakenly attribute your decreased sex drive to a loss of interest in the relationship.

Sleep Disturbances

Insomnia and a general reduction in sleep quality are both common side effects of SSRIs and other antidepressants. One review of research notes that it’s common for antidepressants to affect sleep (though it didn’t mention sertraline by name).

In particular, 17 percent of people using antidepressants experienced sleep disturbances compared to nine percent of people taking a placebo. People who use sertraline may find that they have trouble sleeping or wake up more frequently throughout the night.

There are several ways to deal with sleep disturbances from sertraline, which you can learn about in this guide to better sleep hygiene. One option is simply to wait it out, as this side effect tends to fade away as the medication reaches a steady state in your body.

Another option is to take sertraline in the morning so its concentration is lower by the time you go to bed.

Dizziness

In the long term, sertraline may actually help reduce levels of dizziness in people with chronic dizziness. Despite this, it’s not uncommon to feel dizzy during the first few weeks of using sertraline — potentially a result of lower blood pressure due to the medication (that does not mean that this is a treatment for high blood pressure, by the way).

Dizziness is a short-term side effect of sertraline that usually doesn’t last longer than 2 to 4 weeks (and sometimes even less), but if you notice that frequent dizziness or lightheadedness lasts longer than 4 weeks, contact your healthcare professional to discuss a lower dose of sertraline.

Weight Gain or Weight Loss

Sertraline and other SSRIs are associated with weight fluctuations, although not all people who take these medications will gain or lose weight.

One study suggests that antidepressants may contribute to a long-term increased risk of weight gain. Some research indicates that this is partly because antidepressant use is associated with a higher total calorie intake.

That said, most of the weight gain caused by antidepressants is minimal, with one study finding that high-dosage antidepressant users gain 0.28kg (about 0.6 lbs) per year on average.

There’s also some research out there to suggest that sertraline may actually lead to weight loss, especially if you’re diabetic. After all, one of the other side effects is a loss of appetite.

If you’re concerned about weight gain or weight loss, talk to your healthcare provider.

Loss of Appetite

Like other side effects of sertraline, reduced appetite is usually temporary and should wear off after the first few weeks of use.

The key to avoiding weight loss from sertraline is to try to eat thoughtfully and maintain your pre-sertraline eating habits. By staying consistent with your healthy eating habits and activity level, you’ll be more likely to maintain your body mass and composition while using Zoloft.

Diarrhea

Diarrhea is another common side effect of sertraline. In comparative studies of sertraline and other SSRIs, about 14 percent of people who were prescribed sertraline at a typical dose experienced diarrhea, compared to about seven percent of those on other SSRIs.

Most of the time, diarrhea becomes less frequent and disappears completely as your body adjusts to the medication and your dosage of sertraline reaches a steady state.

This side effect, like others, may often be managed by reducing your dosage of sertraline or switching to a different antidepressant, such as escitalopram (Lexapro^®) or fluoxetine (Prozac^®), which are both less likely to cause diarrhea. If you have persistent diarrhea from sertraline, the best approach is to contact your healthcare provider.

Headaches

The link between sertraline and headaches is a complicated one.

On one hand, headaches are a common side effect of the medication itself. These Zoloft headaches usually disappear after 2 to 4 weeks of use as the medication stabilizes in your body. On the other hand, this SSRI has also been shown to be effective in treating chronic tension-type headaches, according to a small study.

It’s important to discuss what medications you’re taking with your healthcare provider before you start on sertraline.

While some pain relievers — like tramadol and ibuprofen — can interact with sertraline, it’s generally safe to take over-the-counter medications, including Tylenol, if you experience headaches after starting sertraline. But be aware that in some cases, Tylenol may interact with sertraline as they both are metabolized through your liver.

Simple changes to your sertraline usage, such as taking your medication at a different time of day or reducing your dosage, can help to limit or eliminate headaches. If you have persistent or severe headaches from sertraline that don’t improve over time, talk to your healthcare provider.

Dry Mouth

While there’s no clear explanation for dry mouth, researchers believe that the effects of sertraline and other SSRIs on the brain can also affect your digestive system (one of the reasons some people report constipation or diarrhea).

According to clinical trials, 14 percent of people prescribed antidepressants experience some level of dry mouth, compared to nine percent of people who take a placebo.

Dry mouth should go away on its own after several weeks, but it’s also possible to reduce the severity of dry mouth by avoiding:

• Caffeine

• Alcohol (and products containing alcohol, like mouthwash)

• Tobacco

• Spicy foods

• Other foods and drinks that can cause dehydration

Just like many other side effects of sertraline, dry mouth can often be avoided by adjusting your dosage or switching to a different SSRI medication. Sugar-free gums can also help stimulate saliva production and keep your mouth and throat hydrated. There are also over-the-counter mouthwashes, toothpastes, and gels, such as Biotene, that can help manage dry mouth.

Sertraline has been used since the 1990s by tens of millions of people, and in that timeframe, there haven’t been any established side effects specific to long-term use.

With tens of millions of prescriptions in the United States alone, sertraline is one of the most widely used SSRI medications on the market, so there are bound to be anecdotal issues with the medication. But long-term side effects haven’t been identified in scientific studies.

Still, if you see long-term effects as you continue taking sertraline, talk to a healthcare provider.

People who use sertraline may not experience any side effects at all, but it’s also possible for sertraline to cause potentially serious adverse effects for some users. These are quite uncommon, but you should be aware of the warning signs of serious issues.

Some of the potential serious side effects of sertraline include:

• Fainting and extreme dizziness

• Chest pain

• Persistent bleeding

• Suicidal thoughts

• Allergic reaction

Needless to say, if you experience any of these side effects, or your side effects are worsening, you should contact your healthcare provider as soon as possible for medical assistance.

Read on for more details about what to watch out for.

Fainting and Extreme Dizziness

According to the FDA, a small percentage of people who use sertraline may also experience severe dizziness and lightheadedness.

If you feel faint, weak, or severely dizzy or feel changes in your heart rate after taking sertraline, you should seek medical attention as soon as possible.

Chest Pain

A small number of people who use sertraline have reported severe chest pain after taking the medication.

It’s important to point out that this side effect is very rare. Also, chest pain can be a symptom of anxiety, so if chest pain was occurring before the sertraline was started, it might be the anxiety, not the medication. Overall, sertraline is a safe and effective drug that’s widely used successfully, including by people with certain heart problems that make other SSRIs unsuitable.

But if you experience severe or unusual chest pain or shortness of breath after taking sertraline, you should seek medical help as soon as possible.

Persistent Bleeding

Sertraline is one of several SSRIs that may increase the risk of bleeding. This means that while using sertraline, your body might have difficulty forming a normal blood clot if you cut or puncture your skin.

Clotting issues from sertraline use can potentially occur as a result of taking sertraline together with other medications, such as blood thinners, so it’s essential that you inform your healthcare provider of any blood thinners before they prescribe sertraline.

If you develop nose bleeds, bleeding gums while brushing your teeth, or unexplained bruising, talk to your doctor.

Suicidal Thoughts

Sertraline and several other widely used antidepressants can increase your risk of experiencing suicidal thoughts.

The increased risk of suicidal thoughts appears to be present only in young adults up to age 24 or adolescents who take antidepressant medications. The risk is also higher for those who have bipolar disorder or have a family history of bipolar disorder.

If you experience suicidal thoughts after you start using sertraline, seek medical assistance as soon as possible.

Allergic Reaction

Seek immediate medical advice immediately if you experience an allergic reaction to sertraline.

Warning signs of an allergic reaction include hives, swollen face, sore throat, and itching. It’s important to remember that even if these side effects seem particularly mild, they should be reported to a healthcare provider immediately for your safety.

Drug Interactions

Though not a side effect per se, it’s important to know that sertraline can have drug interactions that lead to an increased risk of a life-threatening condition called serotonin syndrome. Some drugs that can lead to serotonin syndrome when taken with Zoloft include:

• Monoamine oxidase inhibitors (MAOIs), like linezolid

• Antipsychotics like pimozide

• St. John's Wort supplements

• Alcohol

Our full sertraline guide goes into more detail on sertraline drug interactions.

If the above list of scenarios worries you, keep in mind that most people who use sertraline either don’t experience any side effects or only have mild side effects that disappear as they become accustomed to the medication.

Most users are fine, safe, and benefiting from this medication. Still, there are some important takeaways to remember:

• Sertraline is safe and effective and typically only causes mild side effects. The most common ones are nausea and diarrhea, headaches, sleep issues, dry mouth, and feeling dizzy or tired.

• The more severe side effects — like fainting and extreme dizziness, chest pain, persistent bleeding, suicidal thoughts, and allergic reactions — are rare. But if you experience them, seek medical attention promptly.

• Make sure to tell your doctor about any health issues and other medications or if you’re pregnant or breastfeeding. They may decide that you shouldn’t take sertraline if you have glaucoma or a history of heart problems.

• Unless you’re experiencing a serious side effect, don’t stop taking sertraline without seeking medical advice. Abruptly stopping sertraline before your next dose could lead to uncomfortable withdrawal symptoms. You can learn more about sertraline or Zoloft withdrawal symptoms in this guide.

Sertraline can hopefully help you regain control over your mental health and day-to-day life. But if you’re concerned or have further questions, it’s best to reach out to a professional.

We can help — we offer access to online psychiatry services, so it’s affordable and convenient to get the medications you need for treatment.