Does Sertraline help with rumination? (9+ disturbing symptoms)

In this article, we will discuss whether Sertraline can help with rumination. We will also discuss how Sertraline can manage negative thoughts and perceptions, and what one should do if this antidepressant doesn’t help. 

Does Sertraline help with rumination?

Sertraline can help with rumination or never-ending negative thoughts. Rumination is a common comorbidity with depression and other mental health conditions that can be treated by Sertraline, like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), etc (1). 

Rumination is a state of persistent negative thoughts that do not go away (2). The person suffering from this condition feels stuck in a loop of negative thought processes which can worsen anxiety and depression. 

They remain focused on the negative parts of their lives and keep thinking about the consequences of their actions, which can also lead to self-hatred and suicidal behaviour in severe cases. Sertraline, being an antidepressant, can help such people. 

However, Sertraline is a prescription medication which should not be used without a doctor’s approval. If you’re struggling with negative, overwhelming thoughts, please reach out to your doctor.

What does research suggest?

Several research studies have indicated that Sertraline can help with rumination and intrusive thoughts. One research study indicated that 12 weeks of treatment with Sertraline can reduce rumination and depression (3). 

Another study presented 2 case studies, one of which included a 53-year-old woman, who was facing severe depression, rumination, and anxiety along with troubling digestive issues. 

She had tried multiple medications, but none were effective (4). Finally, she responded well to Sertraline and her symptoms started to get better. 

The second case included a 56-year-old male who was struggling with rumination, depression, insomnia, etc, which started to get better after the addition of Sertraline to his treatment regimen (4). 

This indicates that Sertraline is a good choice of medication for rumination, and several other symptoms of poor mental health including depression, anxiety, and anhedonia. However, people are different and can respond to Sertraline differently. 

What are the signs and symptoms of rumination?

Rumination is associated with the following signs and symptoms (2):

  • Persistent and intrusive thoughts about past events or mistakes.
  • Repetitive self-blame or guilt for past actions.
  • Dwelling on negative emotions or experiences.
  • Difficulty concentrating on the present moment due to preoccupation with the past.
  • Overanalyzing past decisions or choices.
  • Feeling stuck in a cycle of rumination, unable to break free.
  • Increased anxiety or depression due to rumination.
  • Insomnia or disrupted sleep patterns.
  • Physical symptoms like tension, headaches, or stomach discomfort.
  • Reduced self-esteem and self-confidence.

What to do if Sertraline fails to help you with rumination?

If Sertraline fails to help you with rumination or persistent negative thoughts, please reach out to your doctor. Some mental health illnesses are complex and include other comorbidities. 

Such patients may not respond well to Sertraline monotherapy or a low dose of this antidepressant. Some people may require an antidepressant combination or additional counselling or behavioural therapies to help them cope with rumination and related symptoms (5). 

So, it’s best to discuss your progress with your doctor. If it’s not helping you adequately, your doctor may try dose escalation if it’s possible or may add another medication to your treatment if necessary. Just make sure you do not make any changes to your prescription on your own. 

What are the alternatives to Sertraline for managing rumination?

Some alternatives to Sertraline for the management of rumination include:

  • Cognitive Behavioral Therapy – CBT focuses on changing thought patterns and behaviours associated with rumination, providing effective coping strategies (5).
  • Practices like mindfulness meditation can help individuals become more aware of their thoughts and emotions, reducing rumination.
  • Joining a support group or seeking therapy in group settings can provide valuable insights and coping strategies.
  • Other antidepressants or anti-anxiety medications may be prescribed in cases of severe rumination.

It is important to note that treatment strategies for rumination can vary from person to person and can depend on patient-specific factors. 

This is why it’s important to discuss your symptoms with a qualified mental healthcare professional who can help determine the best course of action to restore your mental peace. 


In this article, we have discussed the role of Sertraline in the management and treatment of rumination. We have also discussed signs and symptoms associated with this condition and what one should do if Sertraline fails to provide adequate relief. 


  1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: 
  1. Sansone RA, Sansone LA. Rumination: relationships with physical health. Innov Clin Neurosci. 2012 Feb;9(2):29-34. PMID: 22468242; PMCID: PMC3312901. 
  1. Kelly O, Matheson K, Ravindran A, Merali Z, Anisman H. Ruminative coping among patients with dysthymia before and after pharmacotherapy. Depress Anxiety. 2007;24(4):233-43. doi: 10.1002/da.20236. PMID: 17004237. 
  1. Maclean L, Ahmedani BK. Sertraline and low-dose doxepin treatment in severe agitated-anxious depression with significant gastrointestinal complaints:two case reports. Prim Care Companion CNS Disord. 2011;13(4):PCC.11l01152. doi: 10.4088/pcc.11l01152. PMID: 22132361; PMCID: PMC3219524. 
  1. Watkins ER, Mullan E, Wingrove J, Rimes K, Steiner H, Bathurst N, Eastman R, Scott J. Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial. Br J Psychiatry. 2011 Oct;199(4):317-22. doi: 10.1192/bjp.bp.110.090282. Epub 2011 Jul 21. PMID: 21778171. 

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