Can Sertraline cause bleeding gums? (3+ factors)

In this article, we will examine whether Sertraline can lead to bleeding gums. We will also explore research studies and factors contributing to bleeding gums when using Sertraline. Finally, we will discuss strategies for managing Sertraline-induced bleeding gums.

Can Sertraline cause bleeding gums?

Sertraline (Zoloft) may or may not cause bleeding gums. This side effect is not frequently reported as a direct side effect of Sertraline. Nevertheless, Sertraline can potentially lead to bleeding problems – which can result in bleeding gums for some individuals (1).

In some instances, bleeding may not be directly associated with the specific antidepressant being taken, and other individual-specific factors, such as underlying health conditions, may cause it. 

If you are experiencing side effects such as dry mouth or bleeding gums while using Sertraline, you should reach out to your healthcare provider.

What does research suggest?

There is limited research on Sertraline-induced bleeding gums and not many cases have been reported. However, antidepressants, particularly SSRIs, are known to cause bleeding disorders, and xerostomia (dry mouth) (1).

A clinical review on SSRIs and their potential bleeding risks has proposed that Sertraline increases the risk of bleeding by inhibiting Serotonin transport proteins in platelets and inhibiting vagal-stimulated serotonin release in the portal circulation (2,3).

Another study focusing on Sertraline-related bleeding tendency has expanded on this by suggesting a third mechanism, involving indirect interaction with glycogen IIb/IIIa surface receptors involved in platelet activation (2,3).

Additionally, this study also presented two cases: one involving an 11-year-old boy receiving treatment for obsessive-compulsive disorder (OCD) with Sertraline and the other involving a 36-year-old woman being treated for OCD and generalized anxiety disorder with Sertraline. It suggested that the risk of bleeding disorders while on this medication is dose-dependent (3).

These mechanisms could explain the mechanism of gum bleeding.

How does Sertraline cause bleeding gums?

Sertraline exerts its effects by elevating serotonin levels in both the central and peripheral nervous systems. Serotonin is a neurotransmitter that is crucial in platelet aggregation and vascular response to damage. Sertraline inhibits serotonin uptake by platelets in the peripheral vascular system causing reduced platelet aggregation and leading to bleeding disorders (2,3).

Sertraline, like other medications, has other side effects such as dehydration and dry mouth which could also contribute to bleeding gums (4).

What factors influence Sertraline-induced bleeding gums?

Several factors can influence Sertraline-induced bleeding gums, including:

  • Individual sensitivity – Some people are more likely to experience bleeding gums due to variations in their body’s response to Sertraline.
  • Dosage – Higher doses of Sertraline may increase the risk of Sertraline’s side effects like bleeding gums.
  • Duration of use – Long-term use of Sertraline may increase the likelihood of bleeding disorders and bleeding gums.
  • Drug interactions – Sertraline interacts with other medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen, increasing the risk of bleeding-related issues like bleeding gums.
  • Underlying medical conditions – Pre-existing medical conditions such as gingivitis can make an individual more susceptible to bleeding gums while taking Sertraline.
  • Lifestyle factors – Poor oral hygiene, smoking, and a low vitamin K diet can contribute to bleeding gums.

What to do if you are experiencing Sertraline-induced bleeding gums?

If you notice bleeding gums while taking Sertraline, it is important to consult your prescribing doctor or a dentist. Your healthcare provider will evaluate your condition, review your medications and offer guidance on how to address the bleeding gums.

Be sure to monitor your symptoms, including the severity of bleeding, and any other changes in your oral health and present them to your doctor.

If your doctor determines Sertraline is causing the bleeding gums, they may recommend adjusting the dosage, tapering off the medication, or switching to an alternative medication with a  lower likelihood of this side effect.

Additionally, maintaining proper oral hygiene is important. Regular, gentle brushing and flossing can help reduce the risk of bleeding gums. Avoid aggressive brushing, as it can further irritate your gums and worsen the bleeding.

If dry mouth is contributing to your bleeding gums, you should drink plenty of water and stay well hydrated to alleviate this side effect.

You should also make lifestyle modifications like quitting smoking and maintaining a rich and well-balanced diet.


While bleeding gums are not a common side effect of Sertraline, they occur in some individuals. It is important to report this side effect to your doctor, stay hydrated and maintain good oral hygiene practices.

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Singh HK, Saadabadi A. Sertraline [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2023 Oct 5]. Available from:




Edinoff AN, Raveendran K, Colon MA, Thomas BH, Trettin KA, Hunt GW, et al. Selective Serotonin Reuptake Inhibitors and Associated Bleeding Risks: A Narrative and Clinical Review. Health Psychology Research [Internet]. 2022 Nov 3 [cited 2023 Oct 5];10(4). Available from:




Eslami Shahrbabki M, Eslami Shahrbabaki A. Sertraline-related bleeding tendency: could it be dose-dependent? Iranian Journal of Psychiatry and Behavioral Sciences [Internet]. 2014 [cited 2023 Oct 5];8(3):81–3. Available from:




Al-Maweri SA, Altayyar MO, AlQahtani KW, Bamasud MS, AlGhamdi OY, Ashraf S, et al. Xerostomia, Salivary Flow, and Oral Health Status Among Saudi Diabetic Patients: A Comparative Cross-Sectional Study. Clinical, Cosmetic and Investigational Dentistry [Internet]. 2021 Nov [cited 2023 Oct 5];Volume 13:451–8. Available from:


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