1. What is sertraline?
Sertraline is an antidepressant medication used to treat depression, panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
It is an SSRI (Selective Serotonin Reuptake Inhibitor), which means that it works by increasing the level of serotonin in the brain.
Sertraline is the generic name for this drug. It’s commonly sold under the brand names Zoloft in the US and Lustral in the UK.
It comes in the form of tablets and is only available on prescription.
2. I feel that my sertraline is not working. How long does it take for sertraline to start to work?
It usually takes 4 to 6 weeks for sertraline to start to work. So if you have just started sertraline and feel that it isn’t helping, it is a good idea to stick with it for the full 6 weeks and see if you start to feel better.
It’s not uncommon to feel worse for the first couple of weeks after starting sertraline, before starting to feel better after a few weeks. If you’ve recently started sertraline and think it’s making your symptoms worse, you can try to stick it out as this usually goes away after a couple of weeks.
However, if at any point you start to have thoughts of suicide or harming yourself, you must see a doctor immediately.
3. I’m experiencing side effects while on sertraline. What ways are there to try to cope with them?
Sertraline can cause a variety of side effects, some of which are common and relatively minor, and some of which are more serious and should be discussed with a doctor as soon as possible.
If you have just started on sertraline or recently increased your dose, you may experience some common side effects. These will probably get better over time as your body adjusts. You can also try taking it just before bedtime so that you’re asleep when its concentration in your body is at its highest, and so the side effects will hopefully have worn off a bit by the time you wake up in the morning.
Some people also feel that their symptoms become worse when they first start taking sertraline, but this usually goes away after a few weeks.
Here is a list of common side effects, and some ways to cope with them:
- Diarrhea – stay hydrated and drink plenty of water in small sips. You may also find it helpful to take oral rehydration solutions
- Nausea – take sertraline with or after food, and try to avoid spicy food
- Feeling tired – take sertraline at night, just before you go to bed
- Difficulty sleeping – take sertraline first thing in the morning, so that this side effect will hopefully have worn off by the time you go to bed in the evening
- Headache – rest and drink plenty of water. If you feel that it would help to take a painkiller, ask a doctor or pharmacist to recommend one which can be taken alongside sertraline. If your headaches don’t go away after a week or they become more severe, see a doctor
- Dizziness – when you feel a bout of dizziness coming on, find somewhere to sit down and rest, and wait for it to pass
- Dry mouth – have sugar-free sweets or chew on sugar-free gum
(For tips on how to cope with sexual side effects, please go to question 5. “Sertraline is affecting my sex life. How can I deal with sexual side effects?”)
The following side effects are serious, and you must see a doctor immediately if you experience them:
- Thoughts about self-harm or suicide
- Severe headache or headaches which last more than a week
- Trouble focusing or memory problems
- Chest pain or shortness of breath
- Severe dizziness or fainting
- Euphoria, excessive enthusiasm or excitement, or feeling restless
- Unexpected changes in your weight
- Yellow skin or eyes
- Painful erections that last for more than 4 hours (priapism)
- Abnormal bleeding, such as bloody stool or unexplained bruises
It is also important to be aware of the signs of an allergic reaction. If you experience an allergic reaction to sertraline, you must see a doctor immediately.
Signs of a serious allergic reaction include:
- Skin rash – for example itchy, red, or swollen skin
- Tightness in the chest or throat
- Trouble breathing or talking
- Swollen mouth, face, lips, tongue, or throat
4. I’m experiencing vivid dreams and nightmares on sertraline. Is this normal?
Some people have vivid dreams or nightmares as a side effect of taking sertraline. This may go away after a few weeks. If they seriously bother you, talk to your doctor and they may suggest switching to a different type of antidepressant medication.
5. Sertraline is affecting my sex life. How can I deal with sexual side effects?
Sertraline, like several other antidepressants, can cause sexual side effects. A common one is a decreased sex drive, and sometimes difficulty achieving orgasm. Men may also experience erectile dysfunction and find it difficult to develop or maintain an erection or have problems ejaculating.
There are several things you can try to help reduce these side effects.
You can wait and see if these side effects go away on their own – antidepressant side effects often appear when you first start taking a new medication or a higher dose and usually go away after a few weeks.
You may also try taking sertraline after the usual time that you have sex, particularly if you are experiencing lowered libido after taking sertraline. Sertraline is usually at its highest in your body soon after you take it, so by adjusting the timing of when you take your medication, the side effects of sertraline should hopefully occur after you have had sex.
If this doesn’t help, talk to your doctor. They may suggest reducing your dose of sertraline, which can sometimes help to lower side effects. Talk to your doctor if you would like to try this – never change your dose of medication without speaking to a doctor first.
Alternatively, your doctor may suggest switching to a different antidepressant or adding another medication, for example, to help with erectile dysfunction in men.
6. What should I do if I overdose on sertraline?
Sertraline overdose can be very dangerous. Signs of overdose include vomiting, shaking, dizziness, feeling sleepy, a fast heartbeat, and seizures. See a doctor immediately if you think you have taken too much sertraline, even if you are not experiencing any symptoms of overdose.
7. What is the best time of day to take sertraline?
You can take sertraline at any time of day. However, if you’re experiencing side effects from taking sertraline, it may help to take your sertraline at a particular time of day.
For example, if sertraline makes it difficult to fall asleep, you can try taking it first thing in the morning so that the worst of this side effect will hopefully have worn off by bedtime.
On the other hand, if sertraline makes you feel tired, you can try taking it just before bedtime, so that it doesn’t interfere with your activities during the day.
Similarly, if sertraline causes you to experience common side effects such as nausea or dizziness, try taking it just before bedtime so that you’re asleep when its concentration in your body is at its highest, so the side effects will hopefully have worn off when you wake up in the morning.
8. How can I safely wean off sertraline? Will I experience withdrawal?
If you’d like to come off sertraline, talk to your doctor so that they can discuss the pros and cons of this with you. Your doctor will help you safely wean yourself off sertraline by gradually reducing your dose over a period of time.
Don’t just stop taking your sertraline abruptly as it can cause symptoms of withdrawal, which can include dizziness, feeling shaky, difficulty sleeping, nausea, and headaches. If you are experiencing withdrawal, talk to your doctor.
Never stop taking your medication without first talking to a doctor.
9. Can I drive while on sertraline?
Sertraline may make you feel tired or affect your concentration, so it is a good idea to avoid driving for a few days after you first start taking it or after recently changing your dose until you’ve seen how sertraline makes you feel. Many people are able to drive while taking sertraline, but it is best to play it safe until you know that sertraline doesn’t impair your driving.
10. Can I have coffee or other caffeinated drinks while on sertraline?
It is generally safe to have coffee while taking sertraline. However, if you are taking sertraline for anxiety or panic attacks, you may find that the caffeine in coffee makes you feel more anxious or makes your symptoms worse. In these cases, it’s a good idea to reduce the number of caffeinated drinks you have per day or avoid them entirely. Talk to your doctor if you would like more advice on having caffeinated drinks while taking sertraline.
11. Can I take sertraline during pregnancy?
This is something that you must discuss with your doctor. Always tell your doctor if you are taking medications and have become pregnant.
Generally, it’s advisable to avoid taking sertraline during pregnancy unless it’s really necessary because it is not yet clear whether sertraline is completely safe to take during pregnancy.
However, it is also important to remain well during pregnancy, and this may mean that it’s necessary to continue taking sertraline.
Talk to your doctor if you are taking sertraline and are planning to become pregnant or have become pregnant. They will help you weigh up the benefits of sertraline to your health, against the possible risks to you and your baby. If necessary, they will help you to safely wean yourself off sertraline by gradually reducing your dose over a period of time.
There is some limited evidence which suggests that taking sertraline during pregnancy may be linked to a slightly increased risk of birth defects and other problems, but current research is limited and it seems that most babies are born healthy even if their mothers took sertraline during pregnancy.
More information can be found on the Medicines in Pregnancy website here.
12. Can I take sertraline while breastfeeding?
This is something that you must discuss with your doctor. Always talk to your doctor if you are taking medications and would like to breastfeed your baby.
Generally, sertraline is thought to be relatively safe to take while breastfeeding if your baby is healthy. It is known to pass into the breast milk in small amounts and may lead to side effects in a very small number of babies. However, it is important to stay well for yourself and your baby.
Talk to your doctor and they will help you weigh up the relative risks and benefits to yourself and your baby, and so that you can decide whether it’s best to stay on sertraline or come off it.
If you do decide to stay on sertraline, talk to your doctor immediately if you notice that your baby isn’t feeding as well as usual or seems unusually sleepy.
13. Will sertraline affect my birth control?
Sertraline will not affect birth control pills or the morning after pill. Talk to your doctor if you have any concerns about sertraline reacting with your contraception.
14. Can I drink alcohol while taking sertraline?
While it is generally considered safe to have alcoholic drinks such as beer or wine while on sertraline, it is possible that it may make you feel sleepy, and you may feel that your alcohol tolerance has become lower. If you have just started taking sertraline, it is probably a good idea to avoid drinking for a while until you’ve seen how sertraline makes you feel.
15. Can I take recreational drugs like cannabis, cocaine, MDMA, or LSD while on sertraline?
It’s best to avoid taking recreational drugs while on sertraline, as they may react with sertraline and cause unpleasant side effects.
It is thought that taking cannabis together with sertraline may make you feel more drowsy.
If you think you may take recreational drugs while on sertraline, please talk to your doctor for advice on how to do this as safely as possible.
16. Can I take painkillers like ibuprofen, paracetamol, or aspirin while on sertraline?
If you need to take a painkiller while on sertraline, ask a doctor or pharmacist to recommend one which is safe for you to take.
Generally, it’s safe to take paracetamol with sertraline. However, you should avoid taking aspirin or NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or naproxen, unless your doctor has advised you to take it alongside your sertraline. This is because they can cause an increased risk of bleeding when taken together with sertraline.
Talk to your doctor if you have any questions or concerns about your medication. Never stop taking your medication without first discussing it with your doctor.
17. Can I take Benadryl or other medications containing diphenhydramine while on sertraline?
Don’t take Benadryl together with sertraline without first checking with a doctor or pharmacist. This is because Benadryl contains the active ingredient diphenhydramine, which when taken together with sertraline may lead to increased side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Talk to a doctor or pharmacist if you would like further advice on sleep aids or allergy medication which can be taken together with sertraline.
18. Can I take Nyquil while on sertraline?
No, you should not take Nyquil with sertraline. This is because most types of Nyquil contain the active ingredient dextromethorphan (amongst others), which must not be taken together with sertraline as the two medications may interact dangerously and cause a serious condition called serotonin syndrome, which has symptoms such as confusion, hallucinations, seizures, fever, blurred vision, and vomiting. If you experience these symptoms, you must see a doctor immediately.
Talk to a doctor or pharmacist for advice on what types of sleep aids or cold and flu medication can be safely taken together with sertraline.
19. Can I take Ambien while on sertraline?
Don’t take Ambien while on sertraline without first checking with a doctor or pharmacist. Ambien contains the active ingredient zolpidem, which when taken together with sertraline may lead to increased side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Talk to a doctor or pharmacist if you would like further advice on sleep aids which can be taken together with sertraline.
20. Is it dangerous to have grapefruit juice while on sertraline?
Yes – avoid eating grapefruit or drinking grapefruit juice while taking sertraline. This is because some chemicals found in grapefruit can prevent sertraline from being broken down, which can cause an unintended increase in the amount of “active” sertraline circulating in the body. This can result in unpleasant and sometimes serious side effects.
The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.
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