Side effects
Some side effects that appear should go away or get better after a few days. If they do not, you should go back to your doctor.
Don't stop taking sertraline until you talk to your doctor or you may get withdrawal symptoms as well.
Very common side effects of sertraline, affecting more than one in ten people, include:
- dizziness or headache
- sleepiness, feeling very tired, or difficulty getting to sleep
- diarrhoea (loose poo)
- feeling sick
- dry mouth
- problems with ejaculating (coming)
Common side effects, affecting up to one in ten people, include:
- sore throat, teeth grinding, or a funny taste in your mouth
- changes in your appetite (feeling hungrier or less hungry)
- having nightmares
- feeling anxious, agitated, depressed, nervous, or just strange
- less interest in sex, or problems having sex - like difficulty getting an erection
- numbness and tingling, tense muscles, having muscle pain, or shaking
- problems with focusing and concentration
- effects on your eyesight
- ringing in your ears
- palpitations, chest pain, hot flushes and sweating
- yawning a lot
- being sick or having stomach and gut pain
- having constipation, an upset stomach, lots of wind
- getting a rash
In clinical trials, young people aged under 25 were more likely than adults to get the following side effects from SSRI medicines:
- thoughts of self-harm and/or taking their own lives
- being hostile or aggressive
The most common side effects reported in children and adolescents are headache, insomnia, diarrhoea and nausea (feeling sick).
Body
A side effect of sertraline may be weight loss or weight gain.
Gaining some weight is more likely, but it is very difficult to know how it will affect each person who takes it.
Talk to your doctor about this if it worries you.
Do not take sertraline at the same time as weight-loss products.
Sleep
You can feel drowsy in the first few days of taking sertraline. This should get better after the first week or two. If it makes you feel drowsy, try taking it just before you go to bed.
You could also, strangely, get insomnia (difficulty getting to sleep), and disturbing dreams or nightmares. If this happens, try taking the tablet first thing in the morning.
If you feel like a zombie, and you’ve been taking it for more than a month, you can go back to the doctor and see what else you could do.
Sex and fertility
Sex
Sertraline can have side effects that might affect your sex life. These might include:
- a lower sex drive
- problems getting an erection (getting hard) and ejaculating (coming)
- a painful erection that lasts for a long time (priapism). If this happens to you, see a doctor for help straight away
- bleeding from the vagina and difficulty reaching orgasm (coming) the same way as before
- some growth of the breasts and milk flow, regardless of gender (this is very rare)
These effects should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to the doctor and see what else you could try.
The good effects of sertraline may, after a while, have a positive impact on your sex life as your mood lifts and you become interested in life and relationships again.
Fertility
There have not been any concerns about fertility problems with sertraline.
If you are trying to get pregnant, you should not take sertraline unless you have talked about it with your doctor.
Pregnancy, post-natal and breastfeeding
Pregnancy
When deciding whether to take sertraline during pregnancy it is important to weigh up how necessary sertraline is to your health against the possible risks to you or your baby, some of which will depend on how many weeks pregnant you are.
Remaining well is particularly important during pregnancy and while caring for a baby. For some women, treatment with sertraline in pregnancy may be the best option for both mother and baby.
If you do become pregnant while you are on sertraline, you should carry on taking the medicine and go back to your doctor as soon as possible, to see if you should stop or change your medicine.
If you and your doctor agree that you will carry on taking sertraline, you should tell your midwife that you are taking it before you give birth.
Post-natal
There are some other symptoms that can occur in newborn babies if sertraline is taken in the last three months of pregnancy, so do look out for these and get help if they happen:
- fits or shaking
- being too hot or cold
- feeding difficulties or being sick
- having stiff or floppy muscles, or overactive reflexes
- being jittery, irritable or having constant crying
- being very sleepy or finding it difficult to sleep
These are usually mild and go away in a few days without treatment.
If sertraline is taken in the last five months of a pregnancy, it can cause a serious condition called persistent pulmonary hypertension of the new-born (PPHN). This can make the baby breathe faster and look a bit blue in colour. PPHN affects around three in 1,000 babies born to mums who take SSRIs. This compares with a rate of two in 1,000 among babies born to mums who do not take SSRIs.
PPHN appears in the first 24 hours after birth. You will need help from the midwife and doctors, so it is better if they are looking out for symptoms.
Breastfeeding
Sertraline passes to the baby through breast milk in small amounts.
Breastfeeding may help offset any withdrawal symptoms.
Please talk to your midwife, doctor or pharmacist if you want to breastfeed while taking sertraline.
Talk to your doctor or midwife about your feeding options.
If your baby was premature or has health problems, then you will need to be extra careful about taking medicines while breastfeeding. It may be best not to breastfeed if this is the case, but you should discuss this with your doctor.
Driving and transport
Taking sertraline may make you feel sleepy, dizzy and restless, and could affect your eyesight when you start taking it.
This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days, until you know how it affects you and your body gets used to it.
Do not worry - most people drive as normal while taking sertraline.
School and exams
Try not to take sertraline for the first time just before your exams.
Sertraline can make you feel very restless in the first few weeks that you take it and may affect you when you sit or stand still.
It can also disturb your sleep, and your eyesight.
You should talk to your doctor about any future exams if you are starting sertraline. You might decide together to delay starting it until you have done them.
If they are more than a month away, however, you might find that it is better to start sertraline to improve your motivation to study.
Do not worry - most people take exams as normal while taking sertraline.
Friends and family
You may want to let your family and friends know you are taking sertraline so they can support you and help you look out for side effects.
For guidance on this, check out our page on getting support with your medication.
Sport
Sertraline is not a banned substance in sport.
Taking sertraline may affect your ability to do things like riding a bike, competitive sports or anything else that needs a lot of focus.
You may also find it difficult to sit or stand still at first.
It might be best to stop such sports for the first few days, until you know how it affects you.
Do not worry - most people play sports as normal while taking sertraline.
Alcohol and street drugs
Alcohol
You can continue to drink alcohol while taking sertraline, but having the two together might make you very sleepy and unsteady on your feet.
During the first few days, it might be best to stop drinking alcohol until you see how the medicine affects you, or the side effects pass.
If you want to drink alcohol, remember that you might be very sleepy and make sure you can get home safely.
Drinking alcohol every day, or in large amounts, can make your symptoms worse and the sertraline will not get the best chance to act.
Street drugs
Methadone and heroin can make drowsiness worse with sertraline. The sertraline could increase the concentration of methadone in your body.
SSRIs may reduce the effects of ecstasy and so might make people try higher doses and therefore get more side effects.
Taking sertraline with cocaine, ecstasy or amfetamines could bring on serotonin syndrome. You could get a high temperature/fever, agitation, confusion, trembling or weird muscle movements. You need to go to hospital if this happens. Tell the doctor that you are taking sertraline.
Sertraline does not seem to be affected by cannabis, although it may make you a bit drowsier.
Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis. For more information, have a look at our drugs and alcohol page.
There are many other street drugs, but we don’t know what effect taking them with sertraline will have.
Prescription medicines
Sertraline does not mix well with some other medicines and drugs.
Do not take sertraline if you are on or have taken MAOIs (drugs like phenelzine, isocarboxazid, tranylcypromine or moclobemide) in the last 14 days; you must wait until 14 clear days have passed before you can take sertraline.
Tell your doctor if you are taking any other medicines.
Tell the pharmacist you are taking sertraline if you buy medicines over the counter (including things you put on your skin) for common illnesses.
References and further reading
For more helpful links and information, have a look at our references and further reading page.