How it works
What does sertraline do?
Sertraline is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI).
Research suggests that depression or low mood is more likely to occur when the brain doesn’t have enough serotonin.
Serotonin (also called '5HT') is a naturally-occurring chemical messenger (or 'neurotransmitter') that has an important role in areas of the brain that control mood and thinking.
Selective serotonin reuptake inhibitors (SSRIs) - like sertraline - are thought to work by increasing levels of serotonin in the brain. They do this by blocking the recycling of released serotonin back into the nerve endings.
Sertraline is often prescribed alongside a talking therapy.
How long does sertraline take to start working?
Antidepressants like sertraline can start to work on depression within the first two weeks of treatment, and the improvement continues over the following few weeks.
It may take four weeks or longer for you to get the full effect.
For anxiety, antidepressants like sertraline can take slightly longer to work. For some people, anxiety briefly increases at the start of treatment, but the anxiety does decrease with continued treatment.
Your doctor will start with a low dose, which they increase slowly to a dose that is effective for you. This may take several days or weeks.
How long will I need to take sertraline?
You will need to take sertraline for several months after you feel better, otherwise your symptoms can come back.
Your doctor will advise you how long to take sertraline for, as it depends on why you are taking it. For depression it might be six months, for OCD it might be 12 months and for other anxiety related conditions such as PTSD and Panic Disorder it might be up to 18 months.
If you stop taking the sertraline too soon, there is more chance that your symptoms will come back.
If you have bipolar disorder, it is likely that the doctor will advise for the sertraline to be stopped sooner. This is because, in bipolar disorder, there is a risk of your mood becoming too high if an antidepressant is used for too long.
See your doctor if you want to stop sertraline.
Your doctor needs to know if...
You need to talk to your doctor or pharmacist before starting treatment with sertraline if you have (or have had) any of the following:
You should only take sertraline as agreed with your doctor
You will get the best effects from your medicine if you take it every day at the dose prescribed by your doctor.
Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.
You will usually take it once a day. When you start treatment, it is recommended that you take it in the morning and not at night, in case it affects your sleep.
To help you to take you tablet regularly you should choose a time that you will remember. This could be a mealtime or when you brush your teeth.
You will start with a low dose, which will be increased slowly to a dose that is effective for you. This may take several days or weeks.
You can take it with or without food.
Swallow the tablet whole with a glass of water - it tastes bitter if you chew it.
Do not drink grapefruit juice while you are taking sertraline - the juice increases the amount of sertraline absorbed from your gut.
What if I miss a dose?
If you remember later during the day, take it as soon as possible.
If you forget to take it by bedtime, just start again on the next day.
Do not take a double dose.
What will happen if I forget to take my sertraline?
If you forget to take your tablets for a few days, you may start getting your old symptoms back, or get withdrawal symptoms (feeling dizzy or shaky, sleep problems [including difficulty sleeping and intense dreams], feeling irritable or anxious, feeling or being sick, and headaches). If this happens you should talk to your doctor about it.
It is important to take sertraline every day, otherwise it will not work.
Stopping the use of sertraline
Stopping this medicine quickly, or reducing the dose too much at once, may cause uncomfortable withdrawal symptoms.
Once you start taking an SSRI, the brain adjusts to having a new level of serotonin around. If you stop taking the SSRI all at once, the balance starts to change again. You could get some symptoms from the change.
Sertraline is not addictive, but you may get uncomfortable withdrawal symptoms if you stop sertraline suddenly, as your body begins to miss it. It is better to agree stopping with a doctor who will reduce you gradually over about four weeks.
Some of the withdrawal symptoms include:
- dizziness or headaches
- tingling feelings like pins and needles or numbness - some people describe electric shock-like feelings down their head and back
- sleep disturbances (vivid dreams, nightmares, not being able to sleep)
- feeling anxious or agitated
- feeling sick or being sick
These symptoms should stop after two to three weeks for most people, but a very few people can get them for two to three months or more.
Most people get mild symptoms, but for a very few people they can be very intense.
Go and speak to your doctor if you have decided to stop taking your medication.