Precautions and Warnings With Sertraline
Some precautions and warnings with sertraline involve an increased risk for health problems such as seizures, suicidal thoughts, and increased bleeding. Other warnings and precautions to be aware of with sertraline concern the effects the medication may have on a person's ability to drive a car or operate heavy machinery. Still other precautions and warnings with sertraline pertain to stopping the medication -- if you stop taking the drug too abruptly, you may experience withdrawal symptoms.
- Bipolar disorder or a family history of bipolar disorder (also known as manic depression)
- A history of suicide attempts or suicidal thoughts
- Seizures or epilepsy
- Liver disease, including liver failure or cirrhosis
- Had a recent heart attack (or if you have unstable heart disease)
- Any allergies, including allergies to food, dyes, preservatives, or latex.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Some warnings and precautions to be aware of with sertraline include the following:
- Antidepressants (including sertraline) may increase the risk of suicidal thinking or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thinking or behavior (see Zoloft and Suicide for more information).
- Before prescribing sertraline for depression, your healthcare provider should make sure that you do not have bipolar disorder (as opposed to depression). Sometimes, the symptoms of bipolar disorder and depression are very similar, and sertraline can cause problems in people with bipolar disorder.
- Antidepressants can cause a group of dangerous symptoms known as serotonin syndrome. Taking sertraline with other medications that affect serotonin can increase your risk of serotonin syndrome. These medications include other antidepressants, triptans (migraine medications), and several other medications (see Drug Interactions With Sertraline for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:
- Fast heartbeat (tachycardia)
- Feeling faint
- Muscle spasms
- Difficulty walking
- Seeing or hearing things that are not really there (hallucinations).
- The dropper that comes with the liquid version of sertraline (sertraline oral concentrate) contains dry natural rubber, which can cause problems for people with latex allergies.
- If you are stopping sertraline, you should be monitored by a healthcare professional for sertraline withdrawal symptoms. If you do develop any symptoms of sertraline withdrawal, such as irritability, anxiety, confusion, headache, lethargy, or insomnia, your healthcare provider may slow down the rate at which the sertraline is stopped (see Zoloft Withdrawal).
- There is a possibility that sertraline may cause unwanted weight loss (see Zoloft and Weight Loss).
- Sertraline may cause bleeding in the stomach or intestines. This risk is increased in those taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Symptoms of gastrointestinal bleeding may include:
- Bright red blood coating the stool
- Dark blood mixed with the stool
- Black or tarry stool
- Bright red blood in vomit
- Vomit that has the appearance of coffee grounds.
If you experience any of these symptoms, call your healthcare provider.
- If you are elderly or taking a diuretic, sertraline could cause low salt levels in the blood (hyponatremia). This generally returns to "normal" when sertraline is stopped.
- Sertraline can interact with certain medications (see Drug Interactions With Sertraline).
- Sertraline may affect your ability to perform complex tasks requiring mental and motor skills. Therefore, you should become accustomed to the effects of sertraline before engaging in activities requiring mental or motor concentration (such as driving a car or operating machinery).
- Sertraline is considered a pregnancy Category C medication. This means that sertraline may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using sertraline during pregnancy (see Zoloft and Pregnancy for more information).
- Sertraline passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using sertraline (see Zoloft and Breastfeeding for more information).
- If you are over 65 years old, your healthcare provider may choose to make necessary dosing adjustments with caution.