Sertraline is a drug of selective serotonin reuptake inhibitor group which is usually used as antidepressant. It effects through increase of the serotonin amount.
It can be prescribed for patients with major depression of the different etiology, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), anxiety disorders, panic disorder, social phobia (social anxiety disorder) and for the depressive episode prophylaxis.
Side effects
Up to 30% of the patients who are taking Sertraline experience side effects. The most common among them are:
- Dry mouth
- Loss of appetite
- Anorexia
- Appetite increased
- Weight loss
- Weight increase
- Nausea
- Vomiting
- Dyspepsia
- Stomach pain
- Upper gastrointestinal bleeding
- Diarrhea
- Constipation
- Headache
- Dizziness
- Weakness
- Asthenia
- Drowsiness
- Mood and behavior changes
- Trouble with concentrating
- Memory problems
- Anxiety
- Irritability
- Aggressiveness
- Activation of mania in patients with bipolar disorder
- Hostility
- Hyperactivity
- Exaggerated feeling of well-being
- Panic attacks
- Depressiveness
- Trouble sleeping
- Rigid muscles
- Loss of coordination
- Hypoesthesia
- Hyperesthesia
- Facial paresthesia
- Overactive reflexes
- Myalgia
- Myoclonic jerking
- Tremor
- Ringing in the ears (tinnitus)
- Flu-like symptoms
- Sweating
- Dry skin
- Pruritus
- Acne
- Alopecia
- Erythematous or maculopapular rash
- Decreased sex desire
- Impotence
- Persistent or painful erection (priapism)
- Abnormal ejaculation
- Difficulty having an orgasm/ anorgasmia
- Dysmenorrhea
- Amenorrhea
- Leucorrhea
Also Sertraline can cause such adverse reactions as:
- Migraine
- Vertigo
- Confusion
- Hallucinations
- Paroniria (nightmares)
- Apathy
- Euphoria
- Yawning
- Twitching
- Ataxia
- Abnormal gait
- Leg cramps
- Decreased bladder control
- Urinary retention
- Polyuria
- Nocturia
- Dysuria
- Periorbital edema
- Conjunctivitis
- Eye pain
- Abnormal accommodation
- Mydriasis
- Nystagmus
- High fever
- Rigours
- Rhinitis
- Sinusitis
- Epistaxis
- Pharyngitis
- Cough
- Dyspnea
- Hot flushing
- Teeth-grinding
- Aggravation of the tooth caries
- Eructation
- Increased salivation
- Dysphagia
- Esophagitis
- Gastroenteritis
- Abdominal pain
- Back pain
- Hypertension
- Hypotension
- Palpitations
- Arrhythmia (fast, slow or irregular heartbeats)
- Chest pain
- Peripheral ischemia
As any other medicine Sertraline can lead to development of the allergic reactions that manifest in rash, urticaria, itching, difficulty swallowing or breathing, tightness in the chest, swelling of the mouth, hands, eyes, face, lips, tongue and throat, unusual hoarseness, angioedema, anaphylaxis, anaphylactic shock and anaphylactoid reactions. These reactions are serious and require urgent medical help.
Rare side effects
Rarely but Sertraline’s use can cause such side effects as seizures, increased odds of a hip fracture, akathisia (in patient with an AV malformation), reductions in the overall time of REM sleep, somnambulism, hyperacusis, labyrinthine disorder, dysphonia, speech difficulties, choreoathetosis, hyporeflexia, hiccup, irritation of the nasal passages, photophobia, ptosis, exophthalmos, xerophthalmia, visual field defect, diplopia, abnormal lacrimation, glaucoma, scotoma, hair loss, acne, eczema, dermatitis, bullous eruption, hypertrichosis, photosensitivity, skin discoloration, pustular rash, jaundice, laryngitis, stomatitis, glossitis, gum hyperplasia, gastritis, diverticulitis, colitis, proctitis, tenesmus, fecal incontinence, muscle pain, arthralgia, arthrosis, cystitis, oliguria, pyelonephritis, strangury, increased libido, breast pain in women, balanoposthitis, atrophic vaginitis, gynecomastia, acute mastitis in women, galactorrhea, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), lupus-like syndrome, serum sickness.
Laboratory test’s changes
Sertraline can also cause some changes in laboratory test’s results. So if your doctor has found some changes, you should remember that such abnormalities as anemia, agranulocytosis, leukopenia, thrombocytopenia, increased coagulation time, asymptomatic elevations of the hepatic enzymes levels (alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase), total cholesterol, triglycerides and HDL cholesterol, and/or LDL cholesterol elevation, hyponatremia, hypoglycemia, hyperglycemia, hypothyroidism, hyperprolactinemia and decrease in serum uric acid can be due to Sertraline intake. Also blood in stool and urine can be found.
ECG changes can include AV block, ventricular and atrial arrhythmias, QT-interval prolongation.
Serious side effects
Sertraline can cause some very serious side effects that can make you to appeal for urgent medical help. These side effects include:
- Suicidal thoughts and behavior
- Worsening of depression
- Extrapyramidal symptoms
- Hallucinations
- Seizures
- Coma
- Septic shock due to agranulocytosis
- Hypoglycemic reaction
- Cataract
- Anterior chamber eye hemorrhage
- Blindness
- Oculogyric crisis
- Optic neuritis
- Hyperventilation
- Hypoventilation
- Shallow breathing or breathing stop (apnea)
- Bradypnea
- Stridor
- Hemoptysis
- Pulmonary hypertension
- Arrhythmias
- Angina
- Myocardial infarction
- Worsening of the hypertention
- Acute renal failure
- Pancreatitis
- Hepatitis
- Liver failure
- Tongue ulceration
- Aphthous stomatitis
- Ulcerative stomatitis
- Hemorrhagic peptic ulcer
- Rectum hemorrhage
- Melena (black stool)
- Intermenstrual bleeding
- Vaginal hemorrhage
- Vasculitis
- Stevens-Johnson syndrome
Also Sertraline discontinuation can lead to withdrawal syndrome development. It can manifest in dizziness, fever, insomnia, lethargy, paraesthesia, nausea, abdominal cramps, vivid and bad dreams, irritability, emotional lability and lowered mood
Side effects in pregnant women
In women of the first trimester Sertraline intake can raise possibility of the birth defects (omphalocele, anal atresia, limb reduction defects, and septal defects).
Side effects in children
Besides the rest common in adult patients adverse reactions in children can develop such side effects as hyperactivity, aggressiveness, fever, sinus inflammation, bloody nose, purpura, urinary incontinence.
Conclusions
You may never experience any of listed above side effects. And your doctor cannot predict reaction of your body to Sertraline until you will try it. That’s why don’t forget to let your physician know if something in your health condition alert you. So when it seems that anything going wrong, ask your doctor for advice and he or she will diagnose if your problem is connected with medicine intake. And be careful because some of Sertraline’s side effects require urgent medical help. Also do not stop intake of Sertraline suddenly because it can cause side effects and worsening of your symptoms.