Does sertraline Cause Flushing? (+ 5 tips)

This article will discuss the potential for flushing as a side effect of sertraline. It will explore the incidence of sertraline-induced flushing, the underlying mechanisms that may cause it, and factors that can influence its occurrence.

Additionally, the article will recommend management strategies to minimize or treat this side effect.

Does sertraline cause flushing?

Sertraline can occasionally cause flushing or hot flashes as a side effect. Although not experienced by everyone, it is important to understand this potential reaction [1]. Sertraline-induced flushing is characterized by reddening and warmth of the skin, typically occurring in the face, neck, and upper chest.

It can last for a few minutes to several hours and may be accompanied by sweating or a sensation of heat. The exact mechanism of how sertraline causes flushing is not fully understood. It is believed that the increase in serotonin levels caused by sertraline can trigger blood vessels to dilate, leading to flushing.

It is important to note that flushing is generally a transient side effect. Most patients find that it resolves on its own without any intervention. However, if the flushing becomes bothersome or persists for an extended period, it is recommended to consult with a healthcare professional.

In some cases, flushing may be accompanied by other side effects of sertraline. These can include nausea, diarrhea, dizziness, or changes in sexual function. It is essential to report any unusual or severe side effects to a doctor to ensure appropriate management and monitoring.

What does research suggest?

Animal studies suggest that serotonin (5-HT) is important for regulating body temperature. Too much serotonin in the hypothalamus can cause temperature increases and flushing. Two types of serotonin receptors, 5-HT1a and 5-HT2a, control temperature in mammals [2].

The 5-HT2a receptor can cause the body to become hotter, while the 5-HT1a receptor can cause it to become cooler. Imbalances between them can lead to flushing or chills. SSRIs, medications that increase serotonin, can stimulate the 5-HT2a receptor and cause temperature changes, resulting in hot flushes [2]

What is the incidence of Sertraline-induced flushing?

Sertraline-induced flushing is very rare. According to a report from the Netherlands Pharmacovigilance Centre Lareb, there were only 10 reports of flushing and 24 reports of hot flushes associated with SSRIs and venlafaxine. Out of these reports, only 1 was specifically about sertraline-induced flushing [3].

Interestingly, a clinical trial was conducted to investigate if sertraline could help in treating hot flashes in menopausal women. The results showed that sertraline reduced the number of hot flashes by five per week and improved the hot flash score compared to a placebo [4].

This indicates that it may be an acceptable alternative treatment for women experiencing hot flashes. Overall, based on the available evidence, flushing as a side effect of sertraline is rare, and the medication can even be beneficial in managing hot flashes in menopause.

What factors may influence sertraline-induced flushing?

Certain factors can influence the occurrence of sertraline-induced flushing. Some of these factors include:

Medications

Combining sertraline with certain drugs can impact sertraline-related flushing. It’s crucial to consider the potential for serotonin syndrome, a condition that arises from excessive serotonin levels in the body.

Since sertraline increases serotonin levels, combining it with other medications that affect serotonin, such as monoamine oxidase inhibitors (MAOIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or triptan medications for migraines, can increase the risk of serotonin syndrome.

Symptoms of serotonin syndrome include flushing, agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, tremors, and muscle rigidity [5].

Moreover, taking medications that dilate blood vessels or increase blood flow, like vasodilators or antihypertensives, can increase the risk of flushing. Certain drugs such as specific antibiotics, calcium-channel blockers, nitrates, nicotinic acid, tamoxifen, thyroid-releasing hormone, and opioids may cause flushed skin as a side effect.

Dose

The dosage of sertraline can play a role in the occurrence of flushing. When taken in high doses, the levels of serotonin can become critically elevated, increasing the risk of serotonin syndrome. You must follow the prescribed dose, apply dose titration, and consult your doctor if you experience any adverse effects.

Underlying health conditions

Certain health conditions can increase the risk of experiencing flushing. Menopause, for example, can lead to hormonal fluctuations that make individuals more susceptible to flushing.

Similarly, individuals with conditions like fever, rosacea, or mastocytosis (characterized by excess mast cell release) may also be at an elevated risk [6].

Moreover, certain endocrine disorders affect blood pressure and cause vasodilation. These disorders can lead to flushing as a symptom. For example, individuals with Cushing’s syndrome, pheochromocytoma, and hyperthyroidism are at an increased risk of flushing [6].

Alcohol consumption

Consuming alcohol while taking sertraline may potentially exacerbate the risk of flushing. Alcohol can dilate blood vessels and induce flushing independently. Combined with sertraline, this effect may be intensified [7].

How can you manage flushing caused by sertraline?

Several management strategies can help minimize or treat flushing caused by sertraline. These strategies include:

Dosing and administration modifications

It is important to apply dose titration by starting with a lower dose of sertraline and gradually increasing it over time to allow your body to adjust to the medication more slowly. This can potentially minimize the occurrence of flushing.

Moreover, taking sertraline with food can help decrease the intensity of flushing. Your healthcare professional may recommend specific meal times or suggest taking the medication alongside a light snack to help mitigate flushing symptoms.

If sertraline-induced flushing is persistent, your doctor may consider adjusting the dosage of sertraline to find the optimal balance between its therapeutic benefits and potential side effects. Lowering the dose may help reduce the intensity or frequency of flushing.

Avoid triggers and interacting medications

Certain triggers, such as alcohol or spicy foods, can exacerbate flushing. Avoiding these triggers or reducing their consumption may help decrease flushing episodes.

Considering potential drug interactions is crucial to minimize the risk of flushing due to serotonin syndrome. It is strongly advised to consult with a healthcare professional to discuss medication interactions, they may prescribe alternative drugs that can be taken alongside sertraline without causing serotonin syndrome.

Cool environment

Keeping the environment cool and comfortable can alleviate flushing symptoms. Using fans, air conditioning, or wearing lightweight clothing can help regulate body temperature and minimize the intensity of flushing.

Topical treatments

Application of calming and cooling lotions or creams to the affected area may provide relief and soothe the skin during flushing episodes.

Medical consultation

If flushing persists or becomes severe, it is important to consult with your healthcare professional. They may recommend additional interventions or alternative treatment options based on your condition.

It is essential to discuss and implement these strategies under the guidance of a doctor to ensure safe and effective management of flushing caused by sertraline.

Conclusion

In conclusion, sertraline can cause flushing as a side effect, characterized by reddening and warmth of the skin. This occurs due to the increased serotonin levels caused by the medication, which can trigger blood vessels to dilate. Flushing is generally transient and resolves on its own in most cases.

If it persists or becomes bothersome, it is recommended to consult with a healthcare professional. Certain factors, such as medication interactions, may influence the occurrence of flushing. Strategies to manage flushing include adjusting the dosage, avoiding triggers, maintaining a cool environment, and using topical treatments.

Overall, flushing caused by sertraline alone is rare, and appropriate management can help alleviate symptoms.

References