Sertraline is one of the most commonly prescribed SSRIs in the UK. Two things about it are worth knowing before you start: it takes weeks rather than days to work, and the first fortnight can feel worse before it feels better — which is exactly when people give up on it.
Depression, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder and social anxiety disorder. It is also used off-label for some other anxiety conditions.
Once daily, with or without food, at the same time each day. Morning suits people who find it disturbs sleep; evening suits those who feel drowsy on it.
Timeline worth having in your head:
Nausea, headache, diarrhoea, difficulty sleeping, dry mouth, sweating and tiredness are common early on and generally settle. Sexual side effects — reduced desire, difficulty reaching orgasm — are common and often persist while taking it; they are worth raising rather than enduring, as options exist.
If you are having a difficult time and need to talk to someone now, the Samaritans are on 116 123, free, at any hour.
Never stop sertraline abruptly. Withdrawal effects — dizziness, electric-shock sensations, nausea, irritability, vivid dreams, flu-like feelings — can be genuinely unpleasant. Coming off it is done gradually, over weeks or months, guided by your GP.
That is also true if you feel completely well. Feeling well is the medicine working, and stopping early is a common route back to relapse.
Tell your prescriber about other antidepressants, triptans for migraine, tramadol, St John’s wort, anti-inflammatories such as ibuprofen, aspirin and anticoagulants — SSRIs increase bleeding risk when combined with those.
Alcohol is best limited, particularly at first; it can worsen both drowsiness and low mood.
Sertraline is one of the SSRIs with more reassuring data in pregnancy and breastfeeding, but this is a decision to make with your GP, not alone.
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