Sertraline

What sertraline is for

Sertraline is a selective serotonin reuptake inhibitor (SSRI). On the NHS it is commonly prescribed for depression, generalised anxiety, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and social anxiety.

It is often used alongside talking therapies such as CBT. Medicine alone is not always enough, and therapy alone is not always enough — many people do best with both.

How to take sertraline

The usual starting dose for adults is often 50 mg once daily, though some people start lower. Take it at the same time each day, with or without food. If it makes you sleepy, evening dosing may suit you; if it makes you restless, morning dosing may be better.

Swallow tablets with water. Liquid forms are available if tablets are difficult. Dose changes should only be made with clinical advice.

What to expect in the first weeks

Side effects often appear before the full benefit. Nausea is common — taking tablets with food can help. You may also notice headache, looser stools, sweating, or vivid dreams.

If anxiety feels briefly worse when you start, tell your GP. This can settle, but you should not struggle alone. Keep taking sertraline as prescribed unless you are told to stop because of a serious reaction.

Side effects and safety

Common effects include nausea, sleep changes, sexual dysfunction and appetite change. Less commonly, SSRIs can increase bleeding risk (especially with NSAIDs or anticoagulants) and, in older people, can contribute to low sodium (hyponatraemia).

Serotonin syndrome is rare. Seek urgent help for high fever, severe agitation, rigid muscles, tremor or a racing heart after starting or combining serotonergic medicines.

Tell a GP about all medicines and supplements you take, including St John’s wort, migraine triptans and some painkillers.

Stopping and long-term use

When you and your GP decide to stop, the dose is usually reduced in steps. Sudden stopping can cause withdrawal symptoms even though sertraline is not “addictive” in the everyday sense.

Treatment length varies. For a first episode of depression, many people continue for at least 6 months after feeling better. Longer courses are sometimes needed for recurrent depression or OCD — your GP will individualise this.

Getting wider support

If you are in England, you can often refer yourself to NHS Talking Therapies without waiting for a GP appointment. If things feel overwhelming, contact Samaritans on 116 123, call 111, or call 999 if you cannot keep yourself safe.

Common questions about sertraline

How long does sertraline take to work?

Some people notice sleep or anxiety changes within 1 to 2 weeks, but the full mood benefit often takes 4 to 6 weeks. If there is little improvement after that, a GP may adjust the dose or consider another option rather than stopping abruptly.

What are the common side effects of sertraline?

Nausea, diarrhoea, headache, dry mouth, sweating, and sleepiness or insomnia are common early on and often improve. Sexual side effects such as reduced desire or delayed orgasm can persist — talk to a GP if these bother you; dose changes or alternatives may help.

Can I drink alcohol on sertraline?

Heavy drinking is best avoided. Alcohol can worsen depression and anxiety and increase drowsiness. Occasional light drinking may be acceptable for some people, but check with a GP or pharmacist if you are unsure.

How do I stop sertraline safely?

Do not stop suddenly. A GP will usually reduce the dose gradually over weeks to lower the chance of dizziness, flu-like symptoms, irritability or "brain zaps". If withdrawal symptoms appear, the taper can be slowed.

Is sertraline addictive?

Sertraline is not addictive in the way alcohol or opioids are, but your body can become used to it. That is why a planned taper matters when stopping. Needing a taper does not mean you have done anything wrong.

Sources

• NHS — Sertraline
• NHS — Antidepressants overview