Do Sertraline-induced tics go away? (3+ tips)

In this article, we will answer the question, “Do Sertraline tics go away?”. We will discuss the relationship between Sertraline and tics, what factors can influence the occurrence of Sertraline-induced tics and how can one manage tics while on Sertraline.

Do Sertraline-induced tics go away?

Yes, Sertraline-induced tics tend to go away on their own once your body adjusts to the medication. Tics or muscle twitches are a side effect of Sertraline that may occur at the start of treatment and then go away once the body adjusts to the medication.

Sertraline is an antidepressant medication belonging to the class of selective serotonin reuptake inhibitors (SSRIs). It has been approved by the FDA for the treatment and management of various depressive illnesses. It has also been used ‘off-label’ to manage conditions like body dysmorphic disorder, binge eating disorder, bulimia nervosa (BN) and premature ejaculation (1,2).

Tics are fast and repetitive involuntary muscle twitches which may result in sudden jolts or movements. There are many causes for the occurrence of tics, one of which is the use of serotonergic medications like Sertraline (3).

Sertraline-induced tics and muscle tension usually resolve in a few weeks once your body adjusts to the medication. Keep in mind that not all individuals taking Sertraline will experience this side effect. However, if you experience Sertraline-induced tics and they do not subside or get worse, reach out to your healthcare provider for guidance.

How does Sertraline cause tics?

The exact mechanism behind Sertraline-induced tics is not known. However, it is found to be related to the changes in the levels of the neurotransmitter serotonin.

Sertraline is a medication that blocks the reuptake of serotonin and subsequently increases its levels in the brain. An abrupt increase in serotonin can cause muscle twitching and tics. These side effects decrease once the body adjusts to the increased levels of the neurotransmitter.

Not all patients on Sertraline experience tics. The occurrence of this side effect depends on the individual characteristics and response to the medication. In rare cases, Sertraline can also cause severe muscular side effects.

How long does it take for sertraline-induced tics to go away?

It typically takes almost two weeks for the body to adjust to Sertraline. If an individual experiences tics following the start of this medication, they should typically resolve within 1-2 weeks after the start of treatment.

It is also possible that these tics do not resolve within a few weeks or worsen over time. In this case, your healthcare provider may adjust the dosage of Sertraline or prescribe you an alternative antidepressant for your depressive illness.

What does research suggest?

Sertraline-induced tics is a rarely reported side effect and not many cases have come to light. However, a few cases reporting the occurrence of tics with the use of Sertraline have been published.

A case study of a 16-year-old girl taking Sertraline for anxiety and depression was published. The study stated the occurrence of tics, which were found to be associated with the use of Sertraline. Removal of Sertraline from the therapeutic regimen resolved the side effects (4).

Another case report of a 78-year-old woman was published who was suffering from Sertraline-induced tics. She was started on the medication one month before the development of this side effect. Discontinuation of Sertraline showed improvement in her symptoms (5).

A case of a 12-year-old child taking Sertraline 125mg/day for obsessive-compulsive disorder was also published. The study reported the occurrence of tics within the first week of treatment. The dosage of Sertraline was reduced to 100mg/day and the tics resolved until the next monthly visit (6).

What factors influence the occurrence of tics while on Sertraline?

The occurrence of tics while taking Sertraline can be influenced by various factors. Some of the factors that may influence the occurrence of tics are as follows:

Factor Details
Underlying medical condition Individuals having Tourette’s syndrome or other tic disorders are at a risk of developing exacerbated symptoms. Sertraline can increase the frequency and severity of the tics in the individual.
Dosage Higher doses of Sertraline have a greater tendency to cause tics. You may need a lower dose if you develop tics while on this medication.
Duration of treatment The usage of Sertraline for extended durations may increase the risk of the development and worsening of tics.
Genetic makeup Genetic conditions predisposing you to the risk of tics can also be a causative agent. Individuals with a family history of tic disorders are at a greater risk for the development of Sertraline-induced tics.
Concurrent medication use Combining Sertraline with other medications that can cause movement disorders can also cause or exacerbate the occurrence of tics or muscle twitches.

How to manage tics while taking Sertraline?

The following tips and strategies can help in the management of tics while taking Sertraline:

Patience and time

If Sertraline use is causing the emergence of tics, be patient and give your body time to adjust to the medication. The symptoms will usually resolve on their own within a few weeks.

Behavioural therapy

Behavioural therapy like habit reversal training (HRT) can be beneficial in resolving tics. This technique includes awareness and competing response training. In addition to this, it also provides individuals with social support and helps them recognise and manage their symptoms.

Medication alternative

Sometimes no amount of managing strategies help in controlling the tics. In this case, the only option is to stop Sertraline treatment and start another antidepressant.

Dosage adjustment

One of the first steps taken, if tics emerge or worsen, is the dosage adjustment of Sertraline. Your healthcare provider may give you a lower dose of the same medication to effectively manage your symptoms.

Avoiding triggers

Specific stimuli, behaviours, noises, or activities may trigger or exacerbate the tics of some individuals. Identification and avoidance or management of such triggers can help in the management of your symptoms as well.

Stay informed

Keeping yourself informed about the potential side effects of Sertraline is good. Being informed about your condition and its manifestations can help you effectively identify and manage your symptoms.

Monitoring by a healthcare professional

Regular monitoring by a healthcare provider is crucial for the timely identification and management of tics.

What to do if tics occur while taking Sertraline?

If tics occur while you are taking Sertraline, you can do the following to help you manage your symptoms:

Stay calm

First and foremost, if you experience tics while on Sertraline make sure to keep calm. Tics, if occurring for the first time can be distressing. Keep in mind this this is a temporary side effect which will pass. Panicking and taking more stress will exacerbate the situation and make it harder to manage this side effect.

Contact your healthcare provider

If you experience tics or have a family history of tic disorders, make sure to communicate this to your healthcare provider. Your doctor will avoid prescribing any such medicine that may put you at risk.

If you are undergoing this while taking Sertraline, it is better to consult your doctor for medical advice. Keep in mind that no medication should be stopped without consulting your healthcare provider.

Monitor your symptoms

Try to monitor your symptoms and keep a record. You can record the triggering factors, frequency and severity of the tics and discuss these with your healthcare provider. The record will aid your doctor in better management of the situation.

Seek support

Seeking support from individuals who have gone through the same problems or are dealing with the same issues as you can be comforting.

Are there any alternative medications less likely to cause tics?

Other SSRIs or SNRIs (serotonin and norepinephrine reuptake inhibitors) can be used as an alternative to Sertraline if this medication causes tics. However, each medication has its side effect profile and the side effects experienced by a patient depend on the individual’s response to the medication.

Medications like citalopram and fluoxetine can be used. Although these medications are safe to use as an alternative, tics have been reported with citalopram in some individuals. Fluoxetine has also been reported to cause muscle twitches in individuals. Keep in mind that the effectiveness of any medication depends on the individual’s characteristics.

To the best of my knowledge and according to clinical evidence, Sertraline-induced tics do go away. This side effect may subside once your body adjusts to the medication. If not, it may resolve when the dose of Sertraline is lowered.

Sometimes, Sertraline may need to be switched with an alternative medication due to this side effect. It is advised to consult a healthcare provider before stopping this medication. However, if Sertraline is necessary, different tips and strategies are available that can help with the management of tics and twitches.

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References

1.-

The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT® (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf 

2.-

Singh HK, Saadabadi A. Sertraline. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/

3.-

Vasan S, Padhy RK. Tardive Dyskinesia. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448207/

4.-

Arasu R, Badeshae S, Furlong Y, Chen W. Sertraline-Induced Tics: A Case Report and Narrative Review. Journal of Pharmacy Practice. 2023 Dec;36(6):1528-31. https://pubmed.ncbi.nlm.nih.gov/35943957/

5.-

Rua A, Damásio J. Tics induced by sertraline: Case report and literature review. Movement Disorders Clinical Practice. 2014 Sep;1(3):243. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353397/

6.-

Desarkar P, Sinha VK. Sertraline caused tics in a child with obsessive-compulsive disorder. Journal of Pediatric Neurology. 2006 Dec;4(04):283-4. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0035-1557335

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