Sertraline is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI).
It's often used to treat depression, and also sometimes panic attacks, obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
Sertraline works by increasing the levels of a mood-enhancing chemical called serotonin in your brain.
It helps many people recover from depression, and has fewer unwanted side effects than older antidepressants.
Sertraline comes as tablets, which are available only on prescription.
Who can take sertraline
Most adults can take sertraline.
Children aged 6 to 17 years can also take sertraline, but only for obsessive compulsive disorder (OCD).
If you have diabetes, sertraline can make it more difficult to keep your blood sugar stable. Your doctor may recommend that you monitor your blood sugar level more often for the first few weeks of treatment with sertraline and adjust your diabetes treatment if necessary.
Who may not be able to take sertraline
Sertraline is not suitable for some people. To make sure it's safe for you, tell your doctor if you:
- have ever had an allergic reaction to sertraline or any other medicine
- have a heart problem – sertraline can make your heart beat faster or cause an irregular heartbeat (arrhythmia)
- are trying to get pregnant, already pregnant or breastfeeding
- have glaucoma – sertraline can increase the pressure in your eye
- have epilepsy or are having electroconvulsive treatment – sertraline may increase your risk of having a fit or seizure
Dosage and strength
Sertraline is available as 25mg, 50mg or 100mg tablets.
The usual dose of sertraline is 50mg a day in adults. But your doctor may start you on a lower dose, then increase it gradually to a maximum dose of 200mg a day.
If you have liver problems, your doctor might give you a lower dose.
The usual dose of sertraline for children aged 6 to 12 is 25mg a day, but this may be increased to 50mg a day after a week.
The usual dose of sertraline for children aged 13 to 17 is 50mg a day.
Children aged 6 to 17 might have their dose increased up to 200mg a day, if needed.
How to take it
Take sertraline once a day. You can take it with or without food.
You can choose to take sertraline at any time, as long as you stick to the same time every day.
If you have trouble sleeping, it's best to take it in the morning.
How long to take it for
Once you're feeling better it's likely that you'll continue to take sertraline for several more months. Stopping before that time can make depression come back.
Most doctors recommend that you take antidepressants for 6 months to a year after you no longer feel depressed.
If you forget to take it
If you occasionally forget to take a dose, skip the missed dose and take your next dose the next day at the usual time.
Never take 2 doses at the same time to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
The amount of sertraline that can lead to an overdose varies from person to person.
Taking too much can cause symptoms such as:
- being sick (vomiting)
- feeling sleepy
- feeling dizzy
- fast heart rate
- fits or seizures
- you take more than your prescribed dose of sertraline
Go to 111.nhs.uk or call 111
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the sertraline packet, or the leaflet inside it, plus any remaining medicine with you.
If you have been feeling better for 6 months or more, your doctor may suggest coming off sertraline.
Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking sertraline for a long time.
This is to help prevent any withdrawal symptoms you might get as a reaction to coming off the medicine.
These can include:
- feeling dizzy
- feeling sick
- numbness or tingling in the hands or feet
- trouble sleeping
- feeling agitated or anxious
Common side effects
These common side effects of sertraline happen in more than 1 in 100 people. There are things you can do to help cope with them:
Keep taking the medicine, but speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects
It happens rarely (in less than 1 in 100 people), but some people may have serious side effects when taking sertraline.
Book an appointment with your doctor if you get:
- changes in your periods, such as heavy bleeding, spotting or bleeding between periods
- weight gain or weight loss without trying
Call a doctor or contact 111 now if:
- you have feelings of overwhelming happiness (euphoria), excessive enthusiasm or excitement, or a feeling of restlessness that means you cannot sit or stand still
- the whites of your eyes turn yellow, or your skin turns yellow (this may be less noticeable on brown or black skin) – these can be signs of liver problems
- you cough up blood or have blood in your pee
- you have black or red poo or blood in your vomit – these can be signs of bleeding from the gut
- you are bleeding from the gums, or get bruises that appear without a reason or that get bigger
Go to 111.nhs.uk or call 111.
- get chest pain or pressure, or shortness of breath
- get headaches, have trouble focusing, have memory problems, cannot think clearly, have weakness, have a seizure or fit, or lose your balance – these can be signs of low sodium levels
- have thoughts about harming yourself or ending your life
- get severe dizziness or pass out
- get painful erections that last longer than 2 hours – this may happen even when you're not having sex
- get any heavy bleeding or bleeding that you cannot stop, such as cuts or nosebleeds that do not stop within 10 minutes
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to sertraline.
A few people may get sexual side effects, such as problems getting an erection or a lower sex drive. In some cases these can continue even after stopping the medicine. Speak to your doctor if you are worried.
Taking sertraline for more than a year has also been linked to a small increased risk of getting diabetes. You'll be regularly checked for this.
Other side effects
These are not all the side effects of sertraline. For a full list, see the leaflet inside your medicine packet.
Sertraline and pregnancy
Sertraline can be taken in pregnancy. Some studies have suggested that sertraline might occasionally affect the development of a baby's heart. However, if there is any risk, it is small, and the majority of babies born to women taking sertraline have a normal heart.
When sertraline is taken in the weeks before delivery it can sometimes cause short-term withdrawal symptoms and, very rarely, breathing problems in your baby. Your baby will be checked after birth and given extra care if needed.
Taking sertraline in the last month of pregnancy may slightly increase your risk of bleeding after delivery. However, because this side effect is rare and can be treated, it's not a reason to stop taking sertraline if you're pregnant.
It's important that mental health problems are well treated during pregnancy as these can affect both you and your baby's wellbeing. Depression and anxiety can sometimes get worse during pregnancy, and after the baby's born.
Speak to your doctor if you become pregnant while taking sertraline. They will help you weigh up the risks and benefits so you can decide on the best treatment for you and your baby.
Sertraline and breastfeeding
If your doctor or health visitor says your baby is healthy, it is OK to take sertraline while breastfeeding. It is one of the preferred antidepressants to take when breastfeeding and has been used by many breastfeeding mothers without any problems.
Sertraline passes into breast milk in very small amounts and has been linked with side effects in very few breastfed babies.
It is important to continue taking sertraline to keep you well. Breastfeeding will also benefit both you and your baby.
Talk to your health visitor, midwife, pharmacist or doctor as soon as possible if:
- your baby is not feeding as well as usual
- your baby seems unusually sleepy
- your baby is irritable or has colic
- you have any other concerns about your baby
Sertraline and fertility
For men, sertraline may reduce sperm quality, but it's not known whether this reduces fertility or not. Speak to your doctor if you're having difficulty trying for a baby.
For women, there's no evidence to suggest that taking sertraline reduces your fertility. Speak to a pharmacist or your doctor if you're trying to get pregnant as they may want to review your treatment.
Cautions with other medicines
Some medicines can affect the way sertraline works and increase the chances of you having side effects.
Tell your doctor if you are taking any of these medicines before starting sertraline:
- any medicines that affect your heartbeat – sertraline can make your heart beat faster or cause an irregular heartbeat (arrhythmia)
- any other medicines for depression that you are taking now or have taken in the past – some antidepressants can affect sertraline to cause very high blood pressure even after you've stopped taking them
Mixing sertraline with herbal remedies and supplements
Do not take St John's wort, the herbal remedy for depression, while you're being treated with sertraline as this will increase your risk of side effects.
There's very little information about taking other herbal remedies and supplements with sertraline. It's not possible to say whether they are safe to take together. They're not tested in the same way as pharmacy and prescription medicines.
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