Does Sertraline make you unable to cry? (+3 insights)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this short article, we will discuss the Sertraline-induced inability to cry and the potential mechanisms through which it occurs. We will also discuss the management strategies.
Does Sertraline make you unable to cry?
Yes, Sertraline can make you unable to cry. Sertraline causes emotional blunting which manifests in the dulling of feelings which makes some people unable to cry (1). This feeling occurs in about half of those who take the drug (2). However, the side effect improves after a few weeks of taking the medication.
Sertraline is a widely used antidepressant that is classified as a selective serotonin reuptake inhibitor (SSRI). It acts by inhibiting the reuptake of serotonin in the brain synapses which leads to accumulation of the neurotransmitter (3). Serotonin plays a role in the regulation of mood and personality and is beneficial in the treatment of depressive disorders (3).
Sertraline and other SSRIs like fluoxetine cause emotional numbness and sadness in 40 to 60% of those taking the drug (2). Emotional blunting is a condition whereby a person’s emotions and feelings are dulled.
People with emotional blunting often cannot cry, even during sad or distressing situations that would have normally initiated a crying episode (1). This may last for several weeks before the drug starts to be effective.
The Sertraline-induced inability to cry usually starts at the initiation of therapy and may last for weeks (1,2). Please do not stop the drug when you feel this side effect. Contact your healthcare provider if you feel that the side effect is becoming bothersome.
How does Sertraline make you unable to cry?
The mechanism through which Sertraline reduces the ability to cry in some patients is thought to be due to delayed onset of action of SSRIs through a mechanism that is not well understood (4).
The administration of SSRIs has been reported to trigger dual serotonin signals with different effects attributed to the release of glutamine and serotonin neurotransmitters at different time points (4). The delayed onset of action is thought to be due to a reduction of the glutamine component of the dual serotonin signal.
Some researchers have also suggested that it could be due to the overmodulation of serotonin pathways by Sertraline (1). Others have hypothesized that Sertraline and other SSRIs may reduce the functional ability of the brain areas that are involved in emotional processing (5).
What does research suggest?
Researchers have reported that 40 to 60% of the persons taking Sertraline will experience a reduced ability to cry when they start taking Sertraline (2). This may last several weeks before the drug starts working (1,2).
It is therefore important that you are aware of this side effect which ordinarily goes away when the drug begins to take effect. You should therefore not stop taking the drug unless the side effects become too bothersome.
Please contact your doctor or pharmacist when you feel that the side effect is getting worrisome.
What factors contribute to the inability to cry while taking Sertraline?
Several factors can contribute to the inability to cry while taking sertraline including the patient’s characteristics, drug interactions and lifestyle (2,6).
Patient characteristics include genetic predisposition and overall health status. About half of the population may not tolerate Sertraline owing to their genetic makeup and are thus likely to experience the effect upon taking the drug (2).
The overall health of a person taking the medication may also contribute. The presence of ailments such as liver or kidney disease may affect the metabolism of Sertraline thereby increasing the risk of having the side effect (6).
Additionally, the interactions between Sertraline and other drugs may lead to increased levels of Sertraline with the potential for toxicity and risk of experiencing the effect (6).
How can the inability to cry while taking Sertraline be managed?
Your inability to cry while taking Sertraline may be reduced, or avoided through several measures including lifestyle changes, such as reduction of alcohol intake and smoking.
If you feel that the drug is becoming too bothersome for you, then you can contact your doctor who will assess your condition and may reduce the dose or prescribe an alternative drug.
Understanding the Sertraline-induced inability to cry
Your inability to cry does not mean that Sertraline is not working. About half of those taking Sertraline will experience the side effect which normally takes a few weeks before it goes away.
I urge you to continue taking the drug during this latent time unless you feel that it is becoming too bothersome. You may contact your doctor who will assess you and decide on the next course of action.
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References
1.-
Holguín-Lew JC, Bell V. “When I Want to Cry I Can’t”: Inability to Cry Following SSRI Treatment. Rev Colomb Psiquiatr. 2013 Dec;42(4):304-10. doi: 10.1016/S0034-7450(13)70026-X. Epub 2013 Dec 31. PMID: 26573114. Available from: https://pubmed.ncbi.nlm.nih.gov/26573114/
2.-
Goodwin GM, Price J, De Bodinat C, Laredo J. Emotional blunting with antidepressant treatments: A survey among depressed patients. J Affect Disord. 2017 Oct 15;221:31-35. doi: 10.1016/j.jad.2017.05.048. Epub 2017 Jun 6. PMID: 28628765. Available from: https://pubmed.ncbi.nlm.nih.gov/28628765/
3.-
Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://pubmed.ncbi.nlm.nih.gov/31613469/
4.-
Fischer AG, Jocham G, Ullsperger M. Dual serotonergic signals: a key to understanding paradoxical effects? Trends Cogn Sci. 2014 Dec 10:S1364-6613(14)00237-X. doi: 10.1016/j.tics.2014.11.004. Epub ahead of print. PMID: 25532701. Available from: https://pubmed.ncbi.nlm.nih.gov/25532701/
5.-
Marazziti D, Mucci F, Tripodi B, Carbone MG, Muscarella A, Falaschi V, Baroni S. Emotional Blunting, Cognitive Impairment, Bone Fractures, and Bleeding as Possible Side Effects of Long-Term Use of SSRIs. Clin Neuropsychiatry. 2019 Apr;16(2):75-85. PMID: 34908941; PMCID: PMC8650205. Available from: https://pubmed.ncbi.nlm.nih.gov/34908941/
6.-
Alomar MJ. Factors affecting the development of adverse drug reactions (Review article). Saudi Pharm J. 2014 Apr;22(2):83-94. doi: 10.1016/j.jsps.2013.02.003. Epub 2013 Feb 24. PMID: 24648818; PMCID: PMC3950535. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950535/
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