Can Sertraline cause microscopic colitis? (3+ useful tips)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
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)
Conclusion
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.
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References
1.-
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 : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9567747/
2.-
Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://pubmed.ncbi.nlm.nih.gov/31613469/
3.-
Nemeth V, Pfleghaar N. Diarrhea. 2022 Nov 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28846339. Available from: https://pubmed.ncbi.nlm.nih.gov/28846339/
4.-
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: https://pubmed.ncbi.nlm.nih.gov/25975862/
5.-
MedlinePlus. Sertraline: MedlinePlus drug information [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2022 Feb 15; cited 2023 Jan 2]. Available from: https://medlineplus.gov/druginfo/meds/a697048.html
6.-
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: https://pubmed.ncbi.nlm.nih.gov/33958059/
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