When do Sertraline-induced side effects start to appear? (3 factors )

In this article, we will discuss when the side effects of Sertraline start to appear, the factors influencing the onset of side effects, early and long-term adverse effects and how to manage them while being treated with Sertraline.

When do Sertraline-induced side effects start to appear?

Some common side effects of Sertraline may start to appear within the first few days of your treatment. These side effects may fade away as your body adjusts to the medicine within a week or two. Your doctor may start your treatment from a low dose and gradually increase it as your body settles in (1).

What are the early side effects of Sertraline?

You may experience some common side effects when you start taking Sertraline; although they may fade away once your body is adjusted to the medication. If the side effects do not go away, immediately inform your doctor.

What are the long-term side effects of Sertraline?

When Sertraline is used for longer periods, it may cause delayed side effects in some patients. You must seek immediate medical assistance if any of these side effects become severe.

  • Sex-related problems in both men and women
  • Loss of control
  • Fatigue
  • Difficult breathing
  • Swelling
  • Loss of concentration
  • Increased risk of bleeding or bruising
  • Tremors
  • Irregular heartbeat
  • Risks of suicidal thoughts
  • Serotonin syndrome (rare but can be life-threatening when taken in higher doses for prolonged periods) (4)

While there is a possibility of experiencing these side effects when using Sertraline, not all patients may experience them. Every person varies in their physiological responses from each other.

It is important to continue Sertraline treatment for 6-18 months once you start feeling better. If you discontinue it, your depression symptoms may return(1,2).

What factors can influence Sertraline-induced side effects?

There are certain factors which may influence the onset of side effects associated with Sertraline (Zoloft), including:

Individual metabolism and sensitivity

If you are hypersensitive to the medicine or have certain underlying conditions like liver disease or kidney disease that affect the metabolism of Sertraline, you may experience the onset of side effects quite early.

Elderly people may be more prone to experience early side effects due to their decreased metabolism and various health problems.

Higher dose  

If you are taking higher doses of Sertraline, you may be more susceptible to experiencing side effects of Sertraline. Talk to your doctor if your side effects are not improving or are worsening during the early phase of treatment.

Your doctor may consider starting with a lower dose and increasing it gradually by 25mg to 50mg increments once a week. This gradual dose increase helps your body adapt to Sertraline, reducing the likelihood of experiencing side effects.

Drug interactions

Certain drugs should not be taken concurrently with Sertraline, as combining these medicines with Sertraline can lead to serious adverse reactions. These drugs include:

  • Monoamine oxidase inhibitors (MAOIs) (including Phenelzine, Isocarboxazid, Tranylcypromine, and Moclobemide)
  • Thioridazine
  • Disulfiram
  • Pimozide (1)

How to manage the side effects of Sertraline?

You may try the following tips to manage the early side effects of Sertraline:

  • Take Sertraline with food to avoid nausea and heartburn.
  • If you feel drowsy with Sertraline, consume it at night.
  • Be cautious while driving if you feel sleepy after taking Sertraline.
  • If you experience difficulty going to sleep, take it in the morning.
  • Drink plenty of water to cope with the feeling of a dry mouth.
  • If you experience night sweats, use comfortable nightwear or stay in a cold environment.


In this article, we discussed the onset of side effects associated with Sertraline (Zoloft), along with factors that can influence when these side effects appear. Some common side effects of Sertraline may appear within the first week of treatment but often diminish as the body adjusts.

Factors like age, patient’s metabolism, sensitivity and dosage all have an impact on the onset of side effects. It is essential to avoid possible drug interactions while using Sertraline, as it can lead to serious adverse reactions.

If any side effect gets prolonged or worsens, you should immediately seek emergency treatment. Sertraline will be more effective if you take the medicine as prescribed by your doctor at the same time each day.

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Zoloft. Highlights of Prescribing Information. FDA [Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf 



MedlinePlus. Sertraline: MedlinePlus drug information [internet]. Bethesda (MD: National Library of Medicine (US); [updated 2022 Feb 15; cited 2023 Jan 2]. Available from: https://medlineplus.gov/druginfo/meds/a697048.html 




Meijer WE, Heerdink ER, van Eijk JT, Leufkens HG. Adverse events in users of sertraline: results from an observational study in psychiatric practice in The Netherlands. Pharmacoepidemiol Drug Saf. 2002 Dec;11(8):655-62. doi: 10.1002/pds.752. PMID: 12512241. Available from: https://pubmed.ncbi.nlm.nih.gov/12512241/


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/ 


Edinoff AN, Akuly HA, Hanna TA, Ochoa CO, Patti SJ, Ghaffar YA, Kaye AD, Viswanath O, Urits I, Boyer AG, Cornett EM, Kaye AM. Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review. Neurol Int. 2021 Aug 5;13(3):387-401. doi: 10.3390/neurolint13030038. PMID: 34449705; PMCID: PMC8395812. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8395812/ 

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