Does Sertraline build up in your system? (+5 factors)

In this article, we will discuss whether Sertraline builds up in your body. We will talk about the factors that are responsible for sertraline accumulation in the body. We will explore potential risks and side effects and how to monitor and manage Sertraline levels in your system.

Does Sertraline build up in your system?

Yes. Sertraline can build up in your system. However, Sertraline reaches steady levels after one week of use and a few more weeks for the body to adjust and get used to it.

Sertraline (brand name Zoloft) is a serotonin-selective reuptake inhibitor (SSRI) that increases serotonergic activity in the body. The steady plasma concentration is achieved after one week of administration of the medication. This is because Sertraline has a half-life, which means a certain period is required to eliminate half of the drug from the body. It is essential to follow the instructions of your healthcare provider regarding dosage and inform them of any adverse effects associated with it (1, 2).

How Sertraline is processed by the body?:

Sertraline is processed by the body through an array of pharmacokinetic steps. After oral administration and absorption of Sertraline, it is taken into the bloodstream through the gastrointestinal tract. It reaches the peak plasma concentration after 4-8 hours of ingestion.

Sertraline possesses low binding affinity, which means a significant amount of the drug is free in the bloodstream for therapeutic effect. It then undergoes hepatic metabolism. After Sertraline is converted to its metabolites by the enzymes, they are eliminated from the body through the urinary system.

The half-life of Sertraline is 24 to 48 hours and the steady state of the drug is achieved after one to two weeks of use.

How long does Sertraline stay in your system?

Sertraline can stay in a person’s body for more than a few days. It has a half-life of 24 to 48 hours, this refers to the duration at which half of the drug is eliminated from the body. It may take approximately a day for half of the medication to be eliminated from the bloodstream. The remaining concentration of the drug further reduces to half within 24 to 48 hours.

However, Sertraline converts into its metabolite desmethyl-sertraline which has a half-life of 66 hours, this means some traces of Sertraline can be present in a person’s body for a few days.

Research findings regarding increased levels of Sertraline in the system:

One study published in Pharmacogenetics and Genomics found age may affect the Sertraline concentration in the body. Elderly individuals were having increased levels of Sertraline as compared to younger individuals. However, it is found that not all studies showed a significant relationship between Sertraline serum levels and age (5, 6).

Individuals with hepatic impairment showed a significant increase in Sertraline levels in the body compared with healthy individuals having no liver impairment. It is recommended to reduce doses of Sertraline with hepatic impairment (7, 8).

What are the factors responsible for Sertraline accumulation in the body?

Sertraline accumulates in the body due to several factors, and awareness of these factors can ensure the safety and efficacy of the medication. Some factors play a key role in Sertraline accumulation in the body.

High Doses

Higher doses of Sertraline or taking more frequent doses than prescribed can lead to accumulation in the body. It is essential to communicate with your healthcare provider regarding the dosing regimen and frequency of taking Sertraline.

Liver and kidney impairment

Liver and kidney impairment can cause the Sertraline to be metabolized and eliminated slowly (2). Patients having compromised kidneys or liver may show slow metabolism and elimination processes. The rate of metabolism is reduced in renal and hepatic-impaired individuals which may increase Sertraline concentration in the body.

Drug Interactions

Certain drugs can interfere with the metabolism of Sertraline causing a decrease in clearance from the body. Always provide your healthcare provider with a list of your current medications. This will help to figure out the potential drug interactions.

Drug metabolism

Drug metabolism may vary from one individual to another; thus, some people metabolize Sertraline, slowly leading to increased levels in the system.


Age can play a key factor in how Sertraline is metabolized and eliminated from the body. Geriatrics may face a slow metabolism rate for Sertraline which can potentially increase the levels of Sertraline in their body. Sertraline, when used for extended periods, can cause Sertraline to build up in the body.

What are the potential risks and side effects of Sertraline accumulation?

Sertraline buildup in the body can potentially lead to potential risks and adverse effects. It is considered that the risk of buildup is possibly caused by having higher doses or long-term treatments than prescribed. Some potential risks and side effects are:

  • Sertraline buildup in the body can increase the risk of Serotonin syndrome, which is a rare side effect characterised by such as high blood pressure, muscle firmness, rapid heart rate, and confusion (3).
  • Sertraline can cause sedative effects on the body. Drug buildup in the body can lead to sedative effects.
  • Increased levels of Sertraline can lead to gastrointestinal issues such as constipation, diarrhoea, and stomach aches.
  • In some cases, increased levels of Sertraline can cause neurological effects such as tremors, dizziness, and difficulty in motor coordination. Accumulation of Sertraline in the body can cause sexual dysfunction such as delayed release, low sex drive, or difficulty in achieving climax (4).
  • High levels of Sertraline can cause cardiovascular effects such as irregular heart rhythms or high blood pressure.

It is not recommended to discontinue or change the dosage of Sertraline as it can lead to severe side effects. If you experience any potential risks or side effects regarding the Sertraline buildup in your body, it is essential to inform your healthcare provider.

How Sertraline accumulation can be managed?

Sertraline accumulation can be managed by different strategies including:

  • Ensure that the patient is prescribed the correct dose. This will be based on their individual need and medical history, and the dose will be increased gradually to prevent excessive accumulation.
  • Visiting your healthcare provider regularly. This will help them to closely monitor your symptoms and make any necessary dose adjustments.
  • Reporting any adverse effects that you experience. Your healthcare provider will be able to help you manage these adverse effects and keep you safe.
  • Laboratory tests are conducted if side effects appear persistently.
  • Impaired liver and kidney patients can have Sertraline buildup in the body, it is essential to take the medication under medical supervision, and should closely be monitored to ensure its safety and efficacy.
  • Avoiding alcohol and illicit drugs. These substances can interact with Sertraline and cause adverse effects.


In this article, we have discussed whether Sertraline can be built into the system. We have also evaluated the factors that can increase the Sertraline level in the body and outlined appropriate management to ensure safety and efficacy.

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HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use ZOLOFT safely and effectively. See full prescribing information for ZOLOFT.


DeVane CL, Liston HL, Markowitz JS. Clinical pharmacokinetics of sertraline. Clin Pharmacokinet. 2002;41(15):1247-66. doi: 10.2165/00003088-200241150-00002. PMID: 12452737.


Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005 Mar 17;352(11):1112-20. doi: 10.1056/NEJMra041867. Erratum in: N Engl J Med. 2007 Jun 7;356(23):2437. Erratum in: N Engl J Med. 2009 Oct 22;361(17):1714. PMID: 15784664.


Li Wai Suen CFDBoyapati RSimpson I, et al
Acute liver injury secondary to sertraline


 Lundmark J, Reis M, and Bengtsson F, Therapeutic drug monitoring of sertraline: variability factors as displayed in a clinical settingTher Drug Monit, 2000. 22(4): p. 446–54.


Rudberg I, Hermann M, Refsum H, and Molden E, Serum concentrations of sertraline and N-desmethyl sertraline in relation to CYP2C19 genotype in psychiatric patientsEur J Clin Pharmacol, 2008. 64(12): p. 1181–8.


Wilner KD, Everson G, Foulds GH, Hansen RA, Shrestra R, McKinley C, et al. Multiple dose pharmacokinetics of sertraline in subjects with varying degrees of hepatic impairment (abstract). 1996. European Neuropsychopharmacology.


Demolis JL, Angebaud P, Grange JD, Coates P, Funck-Brentano C, and Jaillon P, Influence of liver cirrhosis on sertraline pharmacokineticsBr J Cl Pharmacol, 1996. 42(3): p. 394–7.

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