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If you’re struggling with a mental health issue, you’re not alone. 1 in 4 adults will experience a mental health problem of some kind each year in England. As you navigate your way back toward feeling like yourself again, you will be faced with countless options for treatment, from psychotherapy to various medications. Antidepressants are a common choice for many patients.
Some antidepressants can be used as an effective treatment option for much more than just depression. One well-known example is sertraline. In this article, we will explain the ins and outs of sertraline and how it works so you can better understand how it might be able to help you.
What Is Sertraline?
Sertraline is a form of antidepressant known as a selective serotonin reuptake inhibitor or SSRI. As their name implies, SSRIs work by increasing the amount of serotonin in your body. Serotonin is a neurotransmitter that can also act as a hormone. Neurotransmitters like serotonin often help to regulate brain activity, balancing your mood and maintaining healthy sleep patterns.
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What Is Sertraline Used For?
Thanks to its ability to boost serotonin levels, sertraline can be used to treat a variety of mental health conditions, including:
- Major depressive disorder
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder
- Obsessive-compulsive disorder
- Social anxiety disorder
- Panic disorder
- Bipolar disorder
Let’s take a moment to explore these disorders to gain a better understanding of how sertraline might be able to help.
Major Depressive Disorder
Major depressive disorder is a mood disorder that causes prolonged feelings of excessive tiredness, sadness, or loss of interest. Having one or two down days here and there does not equate to clinical depression. Those suffering from major depressive disorder cannot simply lift themselves out of it. Treatment may require psychotherapy as well as antidepressants like sertraline.
Symptoms of major depressive disorder may include:
- Feelings of sadness or emptiness
- Irritability or angry outbursts
- Anxiety
- Suicidal thoughts
- Insomnia and other sleep disturbances
- Loss of appetite or excessive eating
- Trouble focusing
- Lack of interest or motivation.
Post Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder is a mental health condition brought about by witnessing or experiencing a traumatic event. The condition can last for months or even years at a time, causing immense emotional distress to patients suffering from it. Reminders of the trauma may trigger or intensify symptoms.
Symptoms of post-traumatic stress disorder may include:
- Intrusive memories whether in the form of thoughts, dreams or flashbacks
- Trouble sleeping or concentrating
- Intense anxiety
- Detachment from friends and family
- Loss of interest
- Irritability or angry outbursts
- Self-destructive behaviours.
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Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder is an extension of premenstrual syndrome. While both disorders cause emotional and physical symptoms, the symptoms associated with premenstrual dysphoric disorder are typically more severe and have an immense negative impact on the daily lives of those who suffer from it.
Symptoms of premenstrual dysphoric disorder may include:
- Acne
- Bloating
- Breast tenderness
- Emotional sensitivity
- Extreme moodiness
- Irritability or angry outbursts
- Intense anxiety
- Feelings of sadness or hopelessness.
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Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder is a condition in which patients experience a pattern of recurring thoughts, fears, or sensations, also referred to as obsessions. In an attempt to rid themselves of these obsessions, they may perform certain actions (known as compulsions) repetitively, such as washing hands, cleaning, checking things, etc.
Symptoms of obsessive-compulsive disorder may include:
- Following a strict routine
- Performing repetitive behaviours
- Unwanted, aggressive, or horrific thoughts
- Fear of contamination
- Intense anxiety.
Social Anxiety Disorder
Social anxiety disorder, or social phobia, is a mental condition that disrupts a person’s ability to live their daily life. Feelings of nervousness in a social situation are normal for everyone, but those with social phobia suffer from fear and anxiety related to social situations to a much higher degree. In fact, the fear and anxiety are oftentimes debilitating, affecting personal relationships, school, work, and more.
Symptoms of social anxiety disorder may include:
- Fast heartbeat
- Trembling or sweating
- Avoidance of situations where you might be the centre of attention
- Worries about embarrassing yourself
- Analysis of your own performance in a social environment
- Intense anxiety in the time leading up to a social event.
Panic Disorder
Panic disorder is a condition in which people experience frequent panic attacks and often have strong fear about when they may have another one. Panic attacks refer to episodes of intense fear that cause severe physical reactions.
Symptoms of panic disorder may include:
- Chest pains
- Chills
- Hot flashes
- Intense fear or a sense of foreboding
- Pounding heart rate
- Shortness of breath
- Trembling
- Feelings of detachment.
Bipolar Disorder
Bipolar disorder is a mood disorder that causes a person to experience intense emotional highs and lows, referred to respectively as mania and depression. These mood shifts can happen suddenly and frequently, and they may affect a person’s behaviour, energy, sleep patterns, and ability to make judgments.
Symptoms of bipolar disorder may include:
- Decreased need for sleep or insomnia
- Racing thoughts, excessive talkativeness, unusual upbeat energy (mania)
- Poor decision-making
- Fatigue, loss of energy
- Suicidal thoughts, feelings of intense guilt or hopelessness (depression).
Since sertraline can increase serotonin levels and serotonin can help regulate mood, sertraline may be an effective treatment for disorders like these that have an immense effect on both mood and anxiety.
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What Are Normal Doses of Sertraline?
There are various ways to take sertraline, including tablets, capsules, and solutions. Every patient will have unique health concerns that lead to different treatment plans, so follow the instructions of your doctor or pharmacist when taking your selected form of sertraline.
According to the Mayo Clinic, normal doses of sertraline for various disorders are as follows:
- Major depressive disorder: 50 mg per day, up to 200 mg
- Obsessive-compulsive disorder: 50 mg per day, up to 200 mg
- Panic disorder: 25 mg per day, up to 200 mg
- Post-traumatic stress disorder: 25 mg per day, up to 200 mg
- Social anxiety disorder: 25 mg per day, up to 200 mg
- Premenstrual dysphoric disorder: 50 – 150 mg per day during menstrual cycle.
Children ages 6 to 12 may start out at 25 mg.
Research has found that the optimal therapeutic dose of sertraline for most patients suffering from major depressive disorder, depression or depressive symptoms, in general, is indeed 50 mg, as indicated above. However, if patients are not experiencing results within 24 weeks of treatment with sertraline, then a doctor may choose to increase the dosage in weekly increments of 50 mg up to a maximum of 200 mg.
How Does Sertraline Make You Feel?
Like other antidepressants (selective serotonin reuptake inhibitors in particular), sertraline helps improve your mood and lessen your anxiety. With less anxiety, you may find it easier to sleep and eat in healthy amounts. You may also notice an increase in energy and your ability to interact with others on a social level.
Many people fear that antidepressants like sertraline may alter their personalities. But, in reality, the goal of these medicines is to help you start to feel more like yourself again.
Keep in mind that you cannot expect to feel better overnight. You will most likely need to take sertraline consistently for a few weeks before you begin to experience the positive effects.
Is Sertraline a Strong Antidepressant?
There is certainly no shortage of options out there when it comes to antidepressants. However, researchers have taken the time to review massive amounts of studies (over 500 trials assessing 21 different drugs) in order to determine which drugs are the most tolerated and the most effective. The review concluded that sertraline, among 4 other antidepressants, was one of the most reliable, sporting an impressively lower rate of dropouts.
Adverse Effects of Sertraline
Unfortunately, sertraline and other selective serotonin reuptake inhibitors can sometimes cause you to feel worse before you start to feel better. Some evidence indicates that this phenomenon may be due to the fact that the increased rush of serotonin actually suppresses another brain chemical called glutamate for a brief period. After an interval of consistent treatment with the drug, however, glutamate production should return to normal.
No matter what, it is important to remember that you should never stop taking sertraline without first talking to your doctor. Abruptly stopping your sertraline treatment could result in withdrawal symptoms. If you do feel the symptoms of your disorder worsening, contact your physician, and they will help you readjust your dosage.
What Happens to Your Body When You Take Sertraline?
When you take sertraline or other SSRIs, your body experiences an increase in serotonin. Sertraline causes this increase by inhibiting the absorption of already-released serotonin back into your nerve endings. This means that more serotonin is then available to relay messages throughout your brain and body.
Symptoms associated with mental health problems like major depressive disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, obsessive-compulsive disorder, social anxiety disorder, panic disorder, and bipolar disorder are thought to be a result of low serotonin levels in the body. With more serotonin available to perform its duty thanks to drugs like sertraline, depressive and anxious symptoms should lessen over time, helping you feel better.
What Are the Most Common Side Effects of Sertraline?
Just like with any other medication, you may experience some side effects while taking sertraline. Most side effects, however, are mild and should disappear within 1 or 2 weeks.
Common side effects may include any of the following:
- Headaches
- Nausea or vomiting
- Diarrhoea
- Dry mouth
- Increased sweating
- Feeling nervous, restless, fatigued, or drowsy
- Insomnia
- Weight changes (gain or loss, depending on either increased or lessened appetite)
- Dizziness
- Heartburn
- Constipation
If these side effects persist or become severe, contact your doctor to adjust your dosage.
There are some more long-term side effects of sertraline as well. Sexual dysfunction is a common occurrence in both men and women who take the drug. Problems may include decreased sex drive, inability to orgasm or keep an erection, and delayed orgasm.
Serious side effects are less common, but they can occur. Contact your physician immediately if you experience any of the following while taking sertraline:
- Seizures
- Abnormal bleeding or bruising
- Weakness or unsteadiness
- Confusion or memory problems
- Signs of an allergic reaction, such as rash, hives, swelling, or difficulty breathing.
SSRIs may also put you at risk of developing serotonin syndrome. This serious condition occurs when serotonin builds up to excessive amounts in the body. It can be life-threatening, so be on the lookout if you start to experience symptoms like:
- Shivering
- Diarrhoea
- Muscle rigidity
- Fever
- Seizures
- Rapid heart rate or high blood pressure
- Agitation, restlessness, or confusion.
How Does It Feel When Sertraline Is Working?
When sertraline is working, you should start to feel better. Feeling better may entail different experiences for people suffering from different issues, but you may expect less anxiety, a better mood, and increased energy. Remember that you should not stop taking sertraline just because you feel better without first discussing it with your doctor.
How Does Sertraline Work for Anxiety?
Sertraline works for anxiety in the same way that it works for depressive symptoms: it increases serotonin levels. Those who experience depression and anxiety may have a lower amount of serotonin in their brains. Sertraline can help compensate for the discrepancy.
When your serotonin levels are within the normal range, your brain can regulate your mood better. This results in feelings of emotional stability and calmness alongside an improved ability to focus. Thus, you should find yourself feeling anxious less often as your emotions balance themselves.
How Long Does Sertraline Stay in Your System?
Sertraline has a relatively short half-life compared to other antidepressants. This means that it should leave your body relatively quickly once you stop taking it. Research indicates that, within 26 hours, you can expect the drug to be about 50% gone from your body. In a little more than 5 days, it should be almost entirely gone, at around 99%.
Can You Get Withdrawal Symptoms from Sertraline?
While they are not addictive in nature, most antidepressants will still result in withdrawal symptoms if you stop taking them too quickly. Depending on the half-life of the drug, you may experience more or less severe symptoms when you discontinue treatment. Drugs with a short half-life may cause withdrawal symptoms to be more severe, as they leave the body much more rapidly. Sertraline’s short half-life makes it a solid candidate for causing withdrawal symptoms when not discontinued gradually.
Withdrawal symptoms for sertraline can last anywhere from 2 to 3 weeks and may include any of the following:
- Dizziness or headaches
- Brain zaps, tingling sensations like pins and needles or numbness, shock-like sensations down the head and back
- Sleep disturbances (insomnia, vivid dreams, nightmares)
- Feeling anxious or agitated
- Shaking
If you feel ready to stop taking your antidepressant, don’t let withdrawal symptoms discourage you. Your doctor can help you slowly reduce your dosage in a way that makes withdrawal symptoms much less severe or even avoids them entirely. Weaning off sertraline may take around 4 weeks.
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Foods to Avoid When Taking Sertraline
The main food to avoid when taking sertraline is grapefruit or grapefruit juice. Consuming grapefruit products may increase the amount of sertraline in your body. This can then increase your risk of developing side effects associated with sertraline and puts you at greater risk of developing serotonin syndrome.
Citalopram vs Sertraline
Both citalopram and sertraline are in the SSRI classification of antidepressants. However, citalopram is only effective in the treatment of major depressive disorder. Sertraline, on the other hand, may be effective with many other disorders in addition to major depressive disorder, including post-traumatic stress disorder, premenstrual dysphoric disorder, obsessive-compulsive disorder, social anxiety disorder, panic disorder, and bipolar disorder.
Both drugs are taken once daily, although the dosage of citalopram is a bit less than sertraline. They have similar side effects, such as nausea or vomiting, drowsiness, dry mouth, diarrhoea, and sexual dysfunction.
A study comparing the effectiveness of treating depression with citalopram and sertraline found that both were effective and tolerated well by patients. The main difference noticed between the two was that citalopram alleviated symptoms of major depressive disorder more quickly than sertraline. Fast relief may make patients more willing to comply with their prescriptions. However, you should talk to your doctor to weigh the risks and benefits of both drugs to find out which may be the best option for your treatment.
Fluoxetine vs Sertraline
Once again, both fluoxetine and sertraline are in the SSRI classification of antidepressants. Both may provide relief for the following disorders: major depressive disorder, panic disorder, and obsessive-compulsive disorder. Fluoxetine may also help with the eating disorder bulimia nervosa.
Each drug is taken once daily, although it is recommended that fluoxetine be taken in the morning while sertraline can be taken at any time of the day. The daily dosage of fluoxetine is slightly less than sertraline at 20 to 80 mg, depending on what disorder it is treating. Both drugs have similar potential side effects, including weight fluctuations, insomnia, sexual dysfunction, and nausea.
A study comparing the effectiveness of treating major depressive disorder with fluoxetine and sertraline found that, while both drugs were effective, sertraline was tolerated much better by patients in comparison. Some adverse effects occurred in both test groups, but those of fluoxetine seemed to be more severe. Only 9.6% of patients using sertraline discontinued their treatment early due to therapy failure, compared to 19.6% of patients taking fluoxetine. Again, there are risks and benefits to both drugs, so talk to your doctor to find out which is the best fit for you.
Can I just Stop Taking Sertraline?
You should not stop taking sertraline or any other form of antidepressant abruptly and without talking to your healthcare provider. Discontinuing treatment suddenly may result in unpleasant withdrawal symptoms. If you wish to stop taking your antidepressant, ask your doctor to help you wean off the medication slowly. They can gradually reduce your dosage over the course of a few weeks, allowing your body to slowly adjust to the difference in serotonin levels.
Can You Overdose on Sertraline?
It is possible to overdose on any type of antidepressant, including sertraline. Symptoms of sertraline overdose may include any of the following:
- Drowsiness or excessive tiredness
- Dizziness or loss of consciousness
- Agitation
- Mania
- Seizures
- Rapid, irregular, or pounding heartbeat.
If you think you may be overdosing on sertraline, seek medical attention immediately.
Can You Drink Alcohol While Taking Sertraline?
People most commonly overdose on sertraline when taking it alongside other drugs or alcohol. You should avoid drinking alcohol or using recreational drugs while taking any form of antidepressant. Interactions between sertraline and other substances like alcohol may increase overwhelming feelings of tiredness or cause more serious reactions.
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Most Common Questions About Sertraline
Let’s take a moment to discuss the most frequently asked questions about starting treatment with sertraline.
Can I Take Sertraline with Paracetamol?
Paracetamol is a medicine commonly used to relieve pain and reduce high fevers. As of now, there is no research to indicate negative interactions between sertraline and paracetamol. However, you should tell your doctor about all the drugs you take regularly before starting treatment with sertraline.
Can I Take Sertraline with Ibuprofen?
Like paracetamol, ibuprofen is a medicine used to relieve pain associated with arthritis, menstrual cramps, toothaches, headaches, and more. Taking ibuprofen alongside sertraline, however, can be dangerous. Sertraline affects your body’s production of serotonin, a chemical that plays a role in forming blood clots. Ibuprofen thins your blood. Combining the two could greatly increase the risk of unwanted bleeding.
Can I Take Sertraline with Coffee?
There are no negative interactions between caffeine and sertraline, so it should be safe to drink coffee while taking your medication. However, it is important to consider the effect that caffeine can have on your mental health, especially considering the disorders that sertraline is designed to treat. Caffeine can make sleep disturbances, which are already a side effect of sertraline, even worse. It may also increase anxiety levels that your medication is trying to alleviate.
Essentially, is it safe to drink coffee with sertraline? Yes. But, it could work against you in the long run if caffeine aggravates your existing disorders like major depressive disorder or obsessive-compulsive disorder.
Are Sertraline and Zoloft the Same?
Yes, sertraline and Zoloft are the same. Sertraline is the name of the actual antidepressant itself. Zoloft is the brand name that sertraline is sold under. There are generic versions of sertraline available as well. You may be able to find them at your local pharmacy. However, you should take the brand of sertraline that is recommended to you by your physician.
Sertraline: A Personal Decision
Sertraline is a commonly prescribed antidepressant medication that helps to increase levels of serotonin in the brain. This, in turn, elevates your mood. Deciding to start taking sertraline is a very personal decision that you should make with your doctor after considering your individual situation and health history.
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