Does sertraline make you sleepy?

In this article:

• Does sertraline make you sleepy?
• Why does sertraline make you tired?
• Managing sertraline fatigue
• When to see your healthcare provider

In this article

• Does sertraline make you sleepy?
• Why does sertraline make you tired?
• Managing sertraline fatigue
• When to see your healthcare provider

Sertraline, sold under the brand name Zoloft, is an antidepressant medication that falls within the drug class of selective serotonin reuptake inhibitors (SSRIs). The medication is approved by the U.S. Food and Drug Administration (FDA) to treat mental health conditions like obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), social anxiety disorder (SAD), major depressive disorder (MDD), and posttraumatic stress disorder (PTSD). Because sertraline raises your serotonin levels, you might experience some drowsiness while taking this medication. 

Does sertraline make you sleepy?

According to Andrew Yousef, M.D., a double board-certified addiction and emergency medicine physician and medical director of Ikon Recovery, drowsiness and fatigue are possible side effects that can occur while taking sertraline.

“The possible adverse reactions of this medication can include drowsiness, which can vary in duration and intensity among individuals,” Dr. Youssouf says.

However, not everyone who takes sertraline experiences sedative effects.

Claudia Cometa, a PharmD and CEO of Peace Advocacy Group in Clearwater, Florida, says the individual response to sertraline can vary quite a bit. Some find it sedating, and others find it activating.

Other adverse side effects of sertraline can include:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Difficulty falling or staying asleep (insomnia)
• Dry mouth
• Loss of appetite
• Heartburn
• Dizziness
• Headache
• Changes in weight
• Nervousness
• Uncontrollable shaking
• Excessive sweating
• Sexual problems, such as decreased sex drive, inability to get or maintain an erection, delayed or absent ejaculation, delayed orgasm, or inability to have an orgasm

Why does sertraline make you tired?

If you’ve recently started antidepressants, you may be wondering why sertraline makes you tired.

One reason why sertraline might make you tired is because of how it changes your brain chemicals. Serotonin, alongside another neurotransmitter, dopamine, plays a role in your sleep quality (how well and how long you can sleep). “Sertraline increases serotonin levels in brain nerve synapses,” Dr. Cometa states. SSRIs like sertraline can increase the amount of serotonin and dopamine in your brain. Research shows that a higher ratio of serotonin to dopamine in the brain is linked to feelings of tiredness and lethargy. 

In addition, a common side effect of sertraline is insomnia. Insomnia can make it difficult to fall or stay asleep. The condition may also make you wake up too early and be unable to go back to sleep. With insomnia, you may still feel tired once awake, possibly decreasing your energy levels. 

Sertraline-induced sedation is a rare side effect of this antidepressant drug. An estimated 10% of people taking sertraline will experience drowsiness. 

It can usually take a few weeks for feelings of sertraline drowsiness and fatigue to subside after starting this antidepressant. “These effects typically diminish as the body acclimates to the treatment over time,” Dr. Youssouf says. 

Yet, Dr. Cometa notes that sertraline fatigue and drowsiness may never go away for some people. 

Managing sertraline fatigue

Dealing with fatigue or drowsiness while managing your daily obligations can be challenging, but there are ways you can potentially reduce these side effects. 

Know that you can try different strategies to improve your energy levels, even though sertraline can make you sleepy.

Here are some tips for reducing sertraline fatigue: 

• Improve sleep hygiene: Dr. Youssouf recommends maintaining a consistent sleep schedule to reduce sertraline fatigue. Some ways to encourage better sleep include creating a bedtime ritual, turning off all devices, lowering the temperature, and avoiding caffeine before bedtime. 
• Rest: If you feel tired or weak during the day, stop what you’re doing and sit or lie down until the side effects subside. Avoid driving a vehicle or using heavy machinery when sertraline fatigue occurs. 
• Avoid alcohol: You’ll want to avoid drinking alcohol while taking sertraline. Mixing these substances may increase your drowsiness and make you less alert or uncoordinated. 
• Switch medications: If Zoloft affects your ability to complete daily tasks, ask your healthcare provider if you can switch medications. “I would suggest a more activating SSRI, such as Prozac (fluoxetine),” Dr. Cometa says. If you can stop taking sertraline, Dr. Cometa adds that it can take between five to seven days for your body to clear the medication. Please speak with your healthcare provider before stopping your medication. 
• Engage in regular physical activity: Exercise may boost your energy levels. Research shows that it may improve fatigue and energy levels. 
• Take medications at night: If you take your pills in the morning, switching to a nighttime dosage may help with fatigue. “ Most default to the morning, then switch to bedtime if they experience daytime sleepiness,” Dr. Cometa says. Be sure to speak with your healthcare provider before switching to nighttime dosages. 
• Request a lower dose: Your prescribed dose of sertraline may be too high, causing excessive sleepiness. Ask your healthcare provider if they can adjust your medication to a lower dose. 
• Take a precision medicine test: Consider a precision medicine test before starting an antidepressant. “There are precision medicine tests known as pharmacogenomics that can identify genetic variants an individual may have to predict the tolerability and safety of medications like sertraline,” Dr. Cometa says.
• Take time to adjust: There’s a chance that the fatigue will wear off within a few weeks after starting the medication. It can take some time for your body to adjust to the antidepressant. However, if these side effects don’t go away, speak with your healthcare provider. 

“Always take medication exactly as prescribed for the best results,” Dr. Youssouf says. “If any side effects persist, patients should feel comfortable communicating with their healthcare provider at any time for further guidance.”

When to see your healthcare provider

As you take sertraline, it’s important to maintain regular check-ins with your healthcare provider so that you can report any side effects to them immediately. In addition to prolonged sleepiness, other serious side effects of sertraline may require medical attention.

These side effects may include the following:

• Suicidal thoughts, ideations, or attempts
• Aggressiveness
• Agitation, restlessness, anger, or irritability
• Increase in activity and talking more than usual
• Acting on dangerous impulses
• New or worsening anxiety or panic attacks
• Trouble sleeping
• Other unusual changes in mood or behavior

Please seek medical help if you’re experiencing any of these side effects as you use sertraline. 

Sertraline is not the end-all-be-all antidepressant for managing certain mental health disorders. If your symptoms are not improving, your healthcare provider may be able to prescribe you an alternative type of antidepressant. 

“With the multitude of options in this class of medications, as well as other classes, alternatives are available and can be pursued,” Dr. Cometa says.

Here are potential alternatives to sertraline your healthcare provider may recommend:

• Celexa (citalopram)
• Cymbalta (duloxetine)
• Desyrel (trazodone)
• Effexor XR (venlafaxine)
• Lexapro (escitalopram)
• Marplan (isocarboxazid)
• Pamelor (nortriptyline)
• Paxil (paroxetine)
• Pristiq (desvenlafaxine)
• Prozac (fluoxetine)
• Trintellix (vortioxetine)
• Wellbutrin XL (bupropion)
• Xanax (alprazolam)

The drowsiness and fatigue from taking the prescription drug sertraline can make managing daily obligations difficult. While these effects typically subside over time, they never disappear for some people. If you’ve been taking sertraline for several weeks and are still experiencing sleepiness, please speak with your healthcare provider for medical advice.