Sertraline Side Effects: Common, Severe & Long-Term

With tens of millions of prescriptions in the United States alone, sertraline is an FDA-approved and widely used SSRI medication on the market. 

Safe and effective, sertraline has been used since the 1990s by tens of millions of people every year without major side effects. 

Sertraline (often prescribed under the brand name Zoloft) is approved by the Food and Drug Administration for the treatment of many different mental health disorders, such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder or panic attacks, major depressive disorder (MDD), social anxiety disorder (SAD) or premenstrual dysphoric disorder (PMDD). In some cases, it is prescribed (but not FDA-approved) to treat acute bipolar disorder.

However, like all SSRIs, sertraline side effects do exist, and you should be aware of them before you consider treatment.

Most sertraline side effects occur in the first few weeks of treatment and tend to disappear over time. However, some can last for several months or occur at any time while using the medication.

Although rare, it’s possible to experience several more serious side effects if you use sertraline to treat depression, anxiety or any other condition.   

Below, we’ve listed the common and uncommon side effects of sertraline. We’ve also linked to relevant studies and other data to provide some more context on how common or uncommon these side effects really are.

What are the Most Common Side Effects of Sertraline?

Sertraline belongs to a class of medications known as selective serotonin reuptake inhibitors, or SSRIs, according to the book, StatPearls. 

Like other SSRIs, it can cause a range of mild side effects that typically occur during the first few weeks of treatment. 

We’ve listed these common side effects below.

Fatigue and Tiredness

Fatigue and drowsiness are two of the most common side effects of sertraline (Zoloft), as well as several other SSRIs.

If you’re using sertraline to treat depression, fatigue and tiredness from the medication can also be compounded by the effects of depression on your mood. 

It’s very common to feel a little low in energy during the first few weeks of taking sertraline, according to the National Alliance on Mental Illness.

Dealing with fatigue and tiredness from sertraline can be a frustrating experience, but it usually passes. 

As the medication reaches a steady state in your body, you’ll generally start to notice a less pronounced effect on your energy levels before this side effect fades completely.

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

Sexual Problems

Sertraline and other SSRIs can cause a variety of sexual side effects, from difficulty achieving orgasm such as decreased sex drive.

Sexual dysfunction side effects are some of the most common side effects of sertraline and other commonly used SSRI medications.

According to a review of certain studies published in the journal, The Mental Health Clinician, between 40 percent and 65 percent of people who take SSRIs experience some side effects related to sexual desire and performance.

It’s worth noting the research did find that of the SSRIs, sertraline has one of the lower likelihoods of affecting sexual function.

These side effects can affect both men and women. In men, one of the most common side effects is a higher level of difficulty achieving orgasm and ejaculating. 

Some men also experience a lower general level of interest in sex after using SSRIs such as sertraline.

In women, the most common sexual side effect of sertraline and other SSRIs is a lower level of interest in sex.

Like many other sertraline effects, sexual side effects can often fade over time as your body gets used to the medication. 

If persistent, sexual side effects can be treated by adjusting your dosage or switching to a different medication.

Sleep Disturbances

Insomnia and a general reduction in sleep quality are both common side effects of SSRIs and other antidepressants. 

People who use sertraline may find that they now have trouble sleeping, or find themselves waking up frequently throughout the night. Sertraline can also cause you to be more sleepy than usual.

While it doesn’t list the effects of sertraline specifically, a 2017 review of research literature published in the journal, Current Psychiatry Reports, notes that it’s common for antidepressants to affect sleep. 

This review found that the prevalence of insomnia attributed to treatment with SSRIs was 17 percent compared to nine percent taking a placebo. 

Like many other SSRI side effects, the study states that these effects are most common in the short term.

There are several ways to deal with sleep disturbances from sertraline. The first is to wait it out, as this side effect tends to fade away as the medication reaches a steady state in your body. 

It’s also possible to take sertraline in the morning to reduce its concentration by the time you sleep.

Finally, it’s important to avoid caffeine and other stimulants that could prevent you from falling asleep in a normal amount of time. 

Try to only consume coffee, caffeinated soda and energy drinks before noon to avoid them affecting you when it’s time to fall asleep.

Dizziness

It’s not uncommon to feel dizzy during the first few weeks of using sertraline. Like other common side effects, this is thought to be a result of your body adjusting to the medication. 

Dizziness is a short-term side effect of sertraline that usually doesn’t persist for longer than two to four weeks.

Interestingly, sertraline is linked to lower levels of dizziness in the long term in some studies, indicating that it could help you feel less dizzy once the medication stabilizes in your body.

If you notice frequent dizziness or lightheadedness after using sertraline that lasts for more than four weeks, it’s important to contact your healthcare professional to discuss the potential of low blood pressure caused by your sertraline dose. 

This side effect, like most, may be managed by using a lower dose of the medication. However, if this side effect doesn't get better after a few weeks, speak to your healthcare provider.

Weight Gain or Weight Loss

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

Most of the weight gain caused by antidepressants is mild, with a 2017 study from Australia published in the journal, BMJ Open, finding that, on average, high-dosage antidepressant users gain 0.28kg (about 0.6 lbs) per year.

According to a 2018 BMJ UK study, researchers concluded that antidepressants may contribute to a long-term increased risk of weight gain.

Another study published in the journal, Nutrients, found that antidepressant use is associated with a higher total calorie intake.

However, a known side effect of sertraline (discussed more in-depth below) is, in fact, loss of appetite. 

There’s also some research out there to suggest that — at least in the short term — sertraline may actually cause you to lose weight. Especially if you’re diabetic. 

In one smaller study published in the journal, Primary Care Diabetes, involving 33 patients with type 2 diabetes, for instance, researchers found at the end of the 12-week observation period a decrease in overall weight, body mass index and waist circumference, overall. 

If you’re concerned about weight gain or weight loss from sertraline, it’s best to talk to your healthcare provider. 

Most of the time, you can avoid changes in your body mass and composition by monitoring your food intake and maintaining your pre-treatment eating habits while using sertraline.

Loss of Appetite

Sertraline could potentially cause you to have a reduced appetite.

Like other side effects of sertraline, this is usually temporary and should wear off after the first few weeks on the medication. 

The key to avoiding weight loss from sertraline is to talk to your healthcare provider and monitor your food intake. 

By staying consistent with your eating habits and activity level, it’s easier to maintain your body mass and composition while using sertraline or any other SSRI.

Diarrhea

Diarrhea is a 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 those on other SSRIs, according to an article published in the journal, International Clinical Psychopharmacology.

Like many other Zoloft side effects, diarrhea usually occurs in the first few weeks of treatment. 

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.

If you have persistent diarrhea from sertraline, the best approach is to contact your healthcare provider. 

This side effect, like others, may often be managed by reducing your dosage of sertraline or switching to a different antidepressant, such as paroxetine or fluoxetine, which are both less likely to cause diarrhea.

Headaches

It’s possible that you may experience headaches after you start using sertraline, particularly in the first few weeks of treatment. 

Like other common side effects, Zoloft headaches usually disappear after two to four weeks of use as the medication stabilizes in your body.  

The link between sertraline and headaches is a complicated one. 

While headaches have been reported to be a side effect of taking sertraline, according to the Journal of the Association of Physicians of India (in a study of 50 people), sertraline has been shown to be effective in treating chronic tension-type headaches.

While some painkillers can interact with sertraline, it’s safe to take Tylenol® if you experience headaches after starting sertraline. 

Be aware that Tylenol may reduce the effectiveness of sertraline in your body. It is important to discuss what medications you’re taking with your healthcare provider before you start on sertraline.

If you have persistent or severe headaches from sertraline that don’t improve over time, it’s best to talk to your healthcare provider. 

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 get rid of headaches.

Dry Mouth

Finally, dry mouth is a common side effect of sertraline and other antidepressants. While there’s no clear reason for this, researchers believe that the effects of sertraline and other SSRIs on the brain can also affect your gastrointestinal system.

According to the FDA, 14 percent of people prescribed antidepressants experience some level of dry mouth compared to nine percent in placebo. 

Although SSRIs like sertraline are less likely to cause dry mouth than other antidepressants (in one study published in Oral Diseases: Leading in Oral, Maxillofacial, Head and Neck Medicine, it affected about 14 percent of people), it’s still fairly common.

There are several ways to treat dry mouth from sertraline. Like other side effects, dry mouth is often temporary, meaning it should go away on its own over the course of several weeks as the medication reaches a steady state in your body.

It’s also possible to reduce the severity of dry mouth by avoiding caffeine, alcohol, tobacco, any spicy foods and other substances that can cause dehydration. 

Sugar-free gums can also help to stimulate saliva production and keep your mouth and throat properly hydrated. 

It is also recommended that you avoid using mouthwash products that contain alcohol as they can make the problem worse.

Finally, if you have a persistent dry mouth from sertraline, you should talk to your healthcare provider. 

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.

Serious Side Effects of Sertraline

People who use sertraline may not experience any side effects, or may only experience a few of the mild side effects listed above. 

However, it’s also possible for sertraline to cause a variety of potentially serious adverse effects in some users.

Below, we’ve listed some of the serious potential side effects of sertraline. 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.

Fainting and Extreme Dizziness

According to the FDA, fainting is not frequently reported but is still a potential side effect of sertraline. 

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 differences in your heart rate after taking sertraline, you should seek medical help as soon as possible.

Chest Pain

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

If you experience severe or unusual chest pain after taking sertraline, you should seek medical help as soon as possible.

It’s important to point out that this side effect is very rare. 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.

Persistent Bleeding

Sertraline is one of several SSRIs that may increase the risk of bleeding, according to an article published in the journal, Pharmacological Research.

This means that if you injure yourself in a way that results in bleeding while using sertraline, your body might have difficulty forming a normal blood clot.

Clotting issues from sertraline use can potentially occur as a result of taking sertraline together with other medications, such as blood thinners. 

If you use other medications that could affect your clotting ability, it’s essential that you inform your healthcare provider before considering sertraline.

Suicidal Thoughts

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

The risk of suicidal thoughts appears to be the highest in young adults or adolescents who take antidepressant medications.

If you experience suicidal thoughts after you start using sertraline, it’s important to seek medical assistance as soon as possible.

Allergic Reaction 

Like any other medication, it is important to seek immediate medical advice if you experience an allergic reaction to sertraline. 

Warning signs of an allergic reaction include hives, swollen face, sore throat, and anaphylaxis. 

Learn More About the Side Effects of Sertraline

While many of the side effects listed above can look alarming, it’s worth remembering that most people who use sertraline either experience no side effects at all, or light, transient side effects that disappear as they become accustomed to the medication. 

You should not take sertraline if you have glaucoma, a history of heart problems, or are breastfeeding.

For the vast majority of users, it’s a safe, effective and important medication that provides real benefits.

However, in addition to the side effects listed above, sertraline can potentially have drug interactions with a wide range of other medications, substances or supplements, like combining alcohol and sertraline, monoamine oxidase inhibitors (MAOIs), nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or even St. John's Wort.

The use of sertraline with other SSRIs could lead to an increased risk of a life-threatening condition called serotonin syndrome, according to the book, StatPearls. Our sertraline guide goes into more detail on sertraline interactions. 

Be sure to discuss all drugs you are taking, including over-the-counter medicine, with your healthcare professional before taking sertraline.

Do not stop taking sertraline without seeking medical advice. 

Abruptly ending sertraline before your next dose could lead to serious withdrawal symptoms, including eye pain, nausea, headaches, irritability, nightmares, or suicidal thoughts.

Read 25 more facts about sertraline here.