Can Sertraline cause microscopic colitis? (3+ useful tips)

In this article, we will answer the query: “Can Sertraline cause microscopic colitis?” Additionally, we will discuss what the research suggests, who is more prone to microscopic colitis, what the symptoms are, and what to do if you experience microscopic colitis while using Sertraline. 

Can Sertraline cause microscopic colitis?

Yes, Sertraline may cause microscopic colitis, although it is not a common side effect. Gastrointestinal problems such as diarrhoea and constipation are frequently associated with antidepressants, including Sertraline.

If you experience symptoms of microscopic colitis while taking Sertraline, it is important to seek immediate medical attention.

What does research suggest?

Research studies indicate a potential risk of Sertraline causing or worsening microscopic colitis in some patients using it to treat depression (1). The exact mechanism behind Sertraline-induced microscopic colitis is still unknown.

Microscopic colitis may be related to the initiation of the treatment with Sertraline and may subside when Sertraline is discontinued. The risk of Sertraline-induced microscopic colitis has been increased as compared to the previous research studies.

Therefore, your doctor (psychiatrist) and gastroenterologist should work in collaboration to treat the symptoms of microscopic colitis if induced by Sertraline (4). However, not everyone using Sertraline may experience this side effect.

Microscopic colitis is a chronic inflammatory disease of the colon that results from alterations in the immune system. Microscopic colitis may also be associated with other side effects like weight loss, stomach pain, tiredness, and dehydration. In rare cases, it may lead to serious conditions including colon ulcers. 

Sertraline is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). It is commonly prescribed for conditions like major depressive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder and obsessive-compulsive disorder.

Sertraline works by increasing the serotonin levels in the brain, which helps with mood regulation (2). Compared to other SSRIs, Sertraline is more commonly associated with gastrointestinal side effects such as diarrhoea, nausea, vomiting, loss of appetite, weight changes and excessive tiredness (5). 

Who is more prone to microscopic colitis while using Sertraline?

While anyone using Sertraline may develop microscopic colitis, certain factors may increase the risk:

  • Elderly people and women
  • Smoking 
  • Use of medicines like nonsteroidal anti-inflammatory drugs (NSAIDs), proton-pump inhibitors. statins, selective serotonin reuptake inhibitors (SSRIs) 
  • Patients with immune disorders (6)

What are the symptoms of microscopic colitis while using Sertraline?

Symptoms of microscopic colitis when using Sertraline may include:

  • Abdominal pain
  • Severe, watery, non-bloody diarrhoea, often occurring at night
  • Urgent need for bowel movements
  • Weight loss
  • Excessive tiredness
  • Joint pain (6)

Microscopic colitis can affect people differently, with some experiencing occasional symptoms while others may have ongoing and worsening symptoms over time. 

What to do if Sertraline causes microscopic colitis?

If you suspect Sertraline is causing microscopic colitis while treating your depression, please inform your doctor. It is a rare but chronic condition and should be immediately reported to the healthcare provider.

It’s important to consider that this side effect may not be exclusively caused by Sertraline, as other underlying health conditions could also contribute. Your doctor will evaluate your symptoms, medical and family history, and response to treatment. 

In cases of severe or prolonged diarrhoea, stopping the medication may be necessary, but this should only be done under the guidance of your doctor. Abrupt discontinuation of antidepressants like Sertraline without medical consultation is not advisable (2). 

Your doctor will guide you about the signs and symptoms of microscopic colitis before beginning Sertraline treatment. If they suspect a relationship between your prolonged, watery, frequent, and non-bloody stools and microscopic colitis, they may refer you to a gastroenterologist for confirmation.

Upon diagnosis, your doctor will guide you through a tapering plan for Sertraline and switch you to another antidepressant that suits you better. They may also prescribe antidiarrhoeal medications to reduce symptoms and guide in managing the symptoms of microscopic colitis (3).

You may also try to manage the symptoms of microscopic colitis by using the following tips:

  • BRAT diet (banana, rice, applesauce, toast)
  • Staying well hydrated
  • Use of probiotics
  • Antidiarrhoeal medications (only if prescribed by your doctor) (3)


In this article, we discussed the possibility of Sertraline-induced microscopic colitis. While it is not a common side effect, however, research studies have shown a potential risk of microscopic colitis caused by Sertraline in some patients using it to treat depression.

The exact mechanisms of Sertraline-induced microscopic colitis are not fully understood, but the withdrawal of Sertraline under medical supervision may be the only solution. 

If you suspect Sertraline is causing or worsening microscopic colitis, please inform your doctor for proper diagnosis and management of this chronic illness. 

Was this helpful?

Thanks for your feedback!



Cerame A, Cotillas A, Coucheiro P, Franco Soler A. Lymphocytic colitis in the course of a treatment with sertraline. A case report. Eur Psychiatry. 2022 Sep 1;65(Suppl 1):S715–6. doi: 10.1192/j.eurpsy.2022.1845. PMCID: PMC9567747. Available from : 


Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: 


Nemeth V, Pfleghaar N. Diarrhea. 2022 Nov 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28846339. Available from: 


Menon R, Ng C. Sertraline-induced microscopic colitis. Psychosomatics. 2015 May-Jun;56(3):316-7. doi: 10.1016/j.psym.2014.03.008. Epub 2014 Mar 27. PMID: 25975862. Available from: 


MedlinePlus. Sertraline: MedlinePlus drug information [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2022 Feb 15; cited 2023 Jan 2]. Available from: 


Tome J, Kamboj AK, Pardi DS. Microscopic Colitis: A Concise Review for Clinicians. Mayo Clin Proc. 2021 May;96(5):1302-1308. doi: 10.1016/j.mayocp.2021.03.022. PMID: 33958059. Available from: 

Find a supportive therapist who can help with Depression.

Discover the convenience of BetterHelp, an online therapy platform connecting you with licensed and accredited therapists specialized in addressing issues such as depression, anxiety, relationships, and more. Complete the assessment and find your ideal therapist within just 48 hours.


AskYourPharm is user-supported. We may earn a commission if you sign up for BetterHelp’s services after clicking through from this site