Does Sertraline cause nightmares? (3 possible mechanisms)

In this article, we will discuss the topic: “Does Sertraline cause nightmares?” We will also talk about related research findings, possible mechanisms that may induce nightmares with Sertraline and therapies for managing this side effect.

Does Sertraline cause nightmares?

Yes, Sertraline may cause nightmares in some patients. Sertraline and other SSRIs may be associated with nightmares because of their impact on sleep patterns and psychological processes, but not everyone experiences nightmares while taking Sertraline (1).

What does research suggest?

According to research studies, a few patients may experience intense and disturbing dreams when starting Sertraline treatment. Sertraline may also disturb sleep patterns, leading to awakening at night and reducing your sleep time (4).

Sertraline has been widely prescribed for post-traumatic stress disorder (PTSD). This antidepressant may improve sleep in patients with PTSD (7), and help them with nightmares. However, Sertraline may make PTSD-induced nightmares worse in some cases (6).

More research is needed to fully understand the mechanism of Sertraline causing vivid dreams, especially for people with sleep disturbances and to prevent their depression from returning (5). Other SSRIs including Prozac, Lexapro and other antidepressants are commonly associated with unusual dreams (4,2).

What are the mechanisms of Sertraline-induced nightmares?

There are a few mechanisms which may cause nightmares while using Sertraline, including:

Serotonin levels

Sertraline affects serotonin, a neurotransmitter that influences sleep and mood. Altered serotonin levels can impact dream experiences and lead to vivid dreams in some patients (3).

Sleep patterns

Sertraline influences serotonin, which, in turn, affects the sleep-wake cycle and dream patterns. It can affect the REM (rapid eye movement) stage of sleep, increasing the risk of nightmares in some patients (2).

Individual sensitivity

Some patients may be more sensitive to Sertraline’s effects and more prone to experiencing nightmares, particularly those with underlying medical conditions.

How to manage nightmares while taking Sertraline?

Your doctor may suggest some medicines that could help manage nightmares with Sertraline, but more research is needed on the effects of these medicines. Different therapies can also be used for treating nightmares, including:

  • Imagery rehearsal therapy (IRT)
  • Exposure, relaxation, and rescripting therapy (ERRT)
  • Systemic desensitization
  • Eye movement desensitization and reprocessing (EMDR)
  • Cognitive-behavioural treatment for insomnia (CBT-I)
  • Lucid dreaming therapy (LDT)
  • Medications

You may also try practising some relaxation therapies before going to sleep and make your bedroom nice and cosy to enhance the quality of your sleep.

What to do if Sertraline-induced nightmares persist?

If you experience persistent nightmares while taking Sertraline, you should inform your doctor. They may reduce your daily dose and increase it gradually, giving your body time to adjust.

Your doctor may also suggest taking Sertraline in the morning to avoid nightmares. Do not stop taking Sertraline without informing your doctor. If necessary, they will provide a proper tapering plan and replace Sertraline with another well-tolerated antidepressant.

Some patients may experience vivid dreams throughout their treatment with Sertraline. These nightmares may disappear when patients discontinue Sertraline only under the supervision of a medical professional.


While nightmares with Sertraline are not common, they can occur, especially during the initial phase of treatment or when adjusting the dosage. If you believe that Sertraline is causing nightmares, it is important to communicate with your doctor.

They may adjust your dosage, recommend taking Sertraline in the morning, or guide you on how to manage nightmares while taking Sertraline.

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Lappas AS, Polyzopoulou ZA, Christodoulou N, Bozikas VP, Samara MT. Effects of Antidepressants on Sleep in Post-traumatic Stress Disorder: An Overview of Reviews. Curr Neuropharmacol. 2023 Aug 1. doi: 10.2174/1570159X21666230801144328. Epub ahead of print. PMID: 37533247. Available from: 

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