Long-Term Effects of Sertraline on Mental Health

Common Long-Term Side Effects

The American Academy of Child and Adolescent Psychiatry reports that gastrointestinal effects, such as nausea, diarrhea/loose stools, dry mouth, heartburn, and constipation, are common adverse events during extended sertraline use, with a strength of evidence based on clinical trials 1
Autonomic effects, including sweating, diaphoresis, are frequently reported adverse events during extended sertraline use, according to the American Academy of Child and Adolescent Psychiatry, with a moderate level of evidence 1, 2
Sexual dysfunction, such as ejaculatory delay in males, erectile dysfunction, and anorgasmia, is a common side effect of long-term sertraline use, as reported by the American Academy of Child and Adolescent Psychiatry, with a high strength of evidence 1
Weight changes, including potential weight loss or gain, are possible with long-term sertraline use, as noted by the American Academy of Child and Adolescent Psychiatry, with a moderate level of evidence 1, 3

The American Academy of Child and Adolescent Psychiatry warns that all SSRIs, including sertraline, carry a boxed warning for suicidal thinking in patients aged 24 years or younger, with a high strength of evidence 1
Suicidal ideation and behavior occur at a rate of 1% with antidepressants versus 0.2% with placebo, resulting in a risk difference of 0.7% and a number needed to harm (NNH) of 143, as reported by the American Academy of Child and Adolescent Psychiatry, with a high level of evidence 1
Behavioral activation or agitation, characterized by motor or mental restlessness, insomnia, impulsiveness, disinhibited behavior, and aggression, may occur with sertraline use, especially in younger children and those with anxiety disorders, according to the American Academy of Child and Adolescent Psychiatry, with a moderate strength of evidence 1
Mania or hypomania, although rare, can occur with long-term sertraline use, typically appearing later in treatment, and may persist after discontinuation, as noted by the American Academy of Child and Adolescent Psychiatry, with a low to moderate level of evidence 1
Seizures, abnormal bleeding, and serotonin syndrome are rare but serious potential side effects of sertraline, as reported by the American Academy of Child and Adolescent Psychiatry and Praxis Medical Insights, with a low to moderate strength of evidence 1, 2, 3

The American Academy of Child and Adolescent Psychiatry and Praxis Medical Insights recommend gradual tapering when stopping long-term sertraline therapy to avoid withdrawal symptoms, with a moderate strength of evidence 2