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Sertraline

Sertraline is an antidepressant mainly used to help people recover from depression and obsessive compulsive disorder (OCD).

It is only available on prescription and comes as tablets.

Other names for sertraline include Lustral and Serimel.

How sertraline works

Sertraline works by increasing the levels of serotonin in your body. Serotonin is a mood-enhancing chemical in your brain.

The medicine does not change your personality or make you feel intensely happy. It improves your mood so you feel better. 

Sertraline is part of the SSRI (selective serotonin reuptake inhibitor) group of medicines.

Uses of sertraline

Usually you will be prescribed sertraline to help recover from depression. 

Your GP might also recommend it for:

Sertraline is sometimes prescribed to treat anxiety in adults. This is an 'off label' use.

Off-label - what it means

'Off label' use is when a medicine is prescribed in a way that is different to how it was first licensed.

Your doctor may prescribe a medicine off label if they think it will treat your condition effectively.

Common off label uses are when a medicine is prescribed:

  • to treat a condition or age group not listed on the patient information leaflet
  • at a higher or lower dosage than stated on the patient information leaflet

Off label use does not mean that the medicine is unsafe. Your doctor will tell you if they are prescribing the medicine off label. They will only prescribe it if the benefits outweigh any risks.

Talk to your pharmacist or doctor if you have any concerns or questions about off label use.

Get emergency help

You might need emergency help if you get serious side effects, take too much or have a serious allergic reaction to sertraline.

If you take too much

Emergency action required: Call 112 or 999 or your GP if you:

  • take more than your prescribed dose of sertraline

Do not drive yourself to the emergency department (ED). Get someone else to drive or call for an ambulance.

Take the sertraline packet or leaflet plus any remaining medicine if you need to go to hospital.

Serious allergic reactions

Sertraline can cause a serious allergic reaction (anaphylaxis) in rare cases.

Emergency action required: Call 112 or 999 or go to your nearest ED if you:

  • get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • are wheezing
  • get tightness in the chest or throat
  • have trouble breathing or talking
  • mouth, face, lips, tongue or throat start swelling

Serious side effects

Emergency action required: Go to your nearest ED or tell your GP immediately if you:

  • have thoughts about harming yourself or ending your life
  • have fits (seizures)
  • have feelings of euphoria, excessive enthusiasm or excitement, or a feeling of restlessness
  • have yellow skin or eyes
  • get a severe skin rash that causes blistering, particularly on the mouth and tongue
  • feel agitated, confused, have diarrhoea, a high temperature, high blood pressure, excessive sweating and a rapid heartbeat – these are symptoms of serotonin syndrome
  • have a manic episode

Check if you can take sertraline

Adults can be prescribed sertraline for depression or OCD.

Children can only be prescribed sertraline for OCD from age 6 upwards.

Allergy warning

Do not take sertraline if you have ever had an allergic reaction to any medicines in the past.

Talk to your GP before you start to take sertraline if you:

  • have a heart problem as sertraline can speed up or change your heartbeat
  • have ever taken any other medicines for depression - some rarely used antidepressants can interfere with sertraline to cause very high blood pressure
  • have the eye problem glaucoma - sertraline can increase the pressure in your eye
  • are pregnant, trying to get pregnant or are breastfeeding
  • have a history of bleeding disorders or often develop bruises
  • have liver disease

Diabetes and sertraline

Check your blood sugar more often for the first few weeks of taking sertraline, if you have diabetes.

Sertraline can make it more difficult to keep your blood sugar stable. Your GP may adjust your diabetes treatment if necessary.

Contraception and fertility

Sertraline does not affect contraceptive pills or the morning after pill.

If you are able to become pregnant, sertraline will not affect your fertility.

Sperm quality might be reduced temporarily while you are taking sertraline.

Talk to your GP if you have concerns.

Pregnancy and sertraline

Sertraline has been linked to a very small increased risk of problems for your unborn baby. Some of these problems can be serious.

Do not stop taking your medicine unless your GP tells you to.

Non-urgent advice: Talk to your GP:

  • if you become pregnant while taking sertraline
  • about the risks and benefits of sertraline while pregnant

Your GP can help you decide which treatment is best for you and your baby.

Breastfeeding and sertraline

Sertraline passes into breast milk in tiny amounts. This is not known to cause side effects in breastfed babies. But it is possible your baby may experience side effects.

You should continue taking sertraline to keep you well. Breastfeeding will also benefit both you and your baby.

Urgent advice: Talk to your GP or public health nurse as soon as possible if:

  • your baby is not feeding as well as usual
  • your baby seems unusually sleepy
  • you are worried about your baby

When you start taking sertraline

Concentrating might be more difficult while you are taking sertraline.

You should stop driving and cycling for the first few days of treatment. Do this until you know how sertraline affects your ability to drive or cycle.

Thoughts of harming yourself

Thoughts of harming yourself may increase if you have depression or anxiety disorder and start taking sertraline.

These thoughts may increase as sertraline takes time to work. It usually takes about 2 weeks to begin working, but sometimes longer.

Emergency action required: Phone your GP or go to an ED straightaway if:

  • you you have thoughts of harming yourself while taking sertraline

Some people who take sertraline for panic attacks find their anxiety gets worse during the first few weeks of treatment.

You may find it helpful to tell a relative or close friend that you are depressed. Ask them to tell you if they think your depression is getting worse, or if they are worried about changes in your behaviour.

How and when to take sertraline

Always take your medicine exactly as your GP tells you to. Do not stop taking your medicine unless your GP tells you to.

You'll usually take sertraline once a day. Try to stick to the same time every day.

If you have trouble sleeping, you should take it in the morning.

You can take sertraline with or without food.

Avoid grapefruit juice

Do not drink grapefruit juice while you are taking this medicine.

Grapefruit juice can increase the amount of sertraline in your body and increase the risk of side effects.

Alcohol and sertraline

Avoid alcohol when taking sertraline. It may make you sleepy.

Dosage

Usually, doses are 50mg a day if you are an adult.

Your GP might start you on a lower dose and increase it gradually to a maximum daily dose of 200mg.

Lower doses for liver problems

Your GP might give you a lower dose or advise you to take sertraline less often if you have liver problems. 

How long it takes to work

It takes around a week for sertraline levels to build up in your body. It takes a few more weeks for your body to get used to sertraline.

Do not stop taking sertraline after a week or 2 because you feel it is not helping.

Usually it takes between 4 to 6 weeks to feel the full effect.

You might feel worse during the first few weeks of treatment before you begin to feel better.

Talk to your GP if you do not feel any better after 6 weeks.

How long you will need to take sertraline

Once you feel better you will probably continue to take sertraline for several more months.

Most doctors recommend that you take antidepressants for 6 months to a year after you no longer feel depressed.

Stopping before that time can make depression come back.

Long-term use

Sertraline is safe to take for a long time.

Taking sertraline does put you at a low risk of developing diabetes. However, you will be regularly checked for this.

Stopping taking sertraline

Do not stop taking sertraline unless your GP tells you to.

You might get unpleasant withdrawal symptoms if you stop taking sertraline suddenly. These include:

  • dizziness
  • feeling sick
  • numbness or tingling in the hands or feet
  • feeling anxious
  • headaches
  • shaking

Withdrawal symptoms are usually harmless and only last a few days.

You can prevent withdrawal by reducing your dose gradually.

If you forget to take it

Do not worry if you occasionally forget to take your sertraline.

Take your next dose the next day at the usual time.

Never take 2 doses to make up for a forgotten one.

Side effects

Side effects such as nausea and headache are common. They are usually mild and go away after a few weeks.

This usually wears off after a few weeks but speak to your GP if it bothers you - a lower dose may help reduce your symptoms.

Urgent advice: Talk to your GP if these side effects do not go away:

  • feeling sick
  • headache
  • being unable to sleep
  • feeling sleepy
  • diarrhoea
  • dry mouth
  • dizziness
  • feeling tired or weak
  • in men, problems ejaculating

See the patient information leaflet that comes with your medicine for a full list of side effects.

Non-urgent advice: Find your patient information leaflet

Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.

Report side effects

You can report any suspected side effects to the the Health Products Regulatory Authority (HPRA): report an issue - hrpa.ie

Weight loss or gain and sertraline

Sertraline can make you feel more or less hungry than usual, so you may lose or gain weight when you start taking it.

Talk to your GP or pharmacist if you start to have problems with your weight while taking sertraline.

Sex and sertraline

Sertraline may improve your sex life. This might happen as you become interested in life again. 

Negative effects may include:

  • men getting painful erections, problems with getting an erection and problems with ejaculating
  • women having some vaginal bleeding and not reaching orgasm the same as before
  • a lower sex drive

Sexual side effects should pass after the first couple of weeks.

Talk to your GP about treatment options if sexual side effects do not stop and this is a problem for you.

Sertraline and other medicines

Tell your GP or pharmacist if you are taking any other medicines, including herbal remedies, vitamins or supplements.

Some medicines and sertraline can interfere with each other. This can increase your chance of side effects.

Talk to your GP or a pharmacist before taking sertraline if you take:

  • medicines that affect your heartbeat – sertraline can speed up or change your heartbeat
  • other medicines for depression – some antidepressants can interfere with sertraline to cause very high blood pressure

Recreational drugs and sertraline

Sertraline does not seem to be affected by cannabis, although you might feel a little more sleepy.

Sertraline may reduce the effects of ecstasy and so might make people try higher doses and get more side effects.

St John's wort and sertraline

Do not take St John's wort, the herbal remedy for depression, while you are being treated with sertraline. This will increase your risk of side effects.

Fact check

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.