Does Sertraline Make You Tired?

Sertraline, sold under the brand name Zoloft, is one of the most widely prescribed antidepressant medications. It belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Sertraline works by increasing levels of serotonin, a neurotransmitter that regulates mood, in the brain.

While sertraline can be very effective in treating depression, anxiety, and other conditions, it also has the potential to cause certain side effects. One of the more common side effects of sertraline is sleepiness or fatigue.

How Does Sertraline Work?

To understand why sertraline may make some people feel tired, it helps to first understand how the medication works in the brain.

Serotonin is a chemical messenger that helps regulate many important bodily functions, including mood, , appetite, and cognition. People with depression often have lower-than-normal levels of serotonin.

SSRIs like sertraline work by blocking the reabsorption (reuptake) of serotonin into nerve cells. This leaves more free serotonin available in the spaces between nerve cells, which improves communication between them.

Increasing serotonin levels can help boost mood and relieve symptoms of depression. However, it also impacts other serotonin-related processes like sleep and drowsiness.

What Causes the Tiredness?

There are a few possible reasons why sertraline may cause feelings of fatigue or sleepiness in some people:

1. Sedative Effect

Sertraline has mild sedative effects, meaning it can cause feelings of , calmness, and drowsiness. This may be more noticeable when first starting treatment or after an increase in dosage.

The sedation is caused by serotonin's natural calming effects on the central nervous system. For those already experiencing fatigue from depression, the sedative effects of sertraline may compound this.

2. Restoring Normal Sleep Patterns

Depression often causes sleep disturbances like or restless sleep. By easing depressive symptoms, sertraline allows some people to fall into a more normal and restful sleep pattern.

The transition from poor sleep to regular sleep can mean spending more time actually asleep at night. Daytime drowsiness may persist until the body adjusts to the improved sleep quality.

3. Indirect Factors

There are also some indirect ways sertraline may contribute to fatigue, including:

  • Decreased motivation – Sertraline may reduce drive and motivation before positive effects like improved mood kick in. This can be perceived as tiredness.
  • Headaches – Headaches are a potential side effect, which can indirectly worsen fatigue.
  • Appetite changes – Some gain or lose their appetite on sertraline, potentially leading to issues like low energy from poor nutrition.
  • Medication interactions – Combining sertraline with certain other drugs may increase drowsiness.

Who is Most At Risk for Tiredness?

Most people taking sertraline do not experience significant drowsiness or fatigue. Those most likely to notice increased sleepiness include:

  • People taking higher sertraline doses – Sedative effects become more apparent at 200 mg per day or more.
  • Elderly patients – Increased sensitivity means the elderly often require lower doses.
  • Those also taking sedatives – Anti-anxiety meds, sleep aids, and some painkillers can compound drowsiness.
  • People misusing alcohol – Alcohol and sertraline both cause drowsiness and should not be mixed.
  • Individuals with sleep disorders – Sertraline may worsen issues like sleep apnea, narcolepsy, or restless leg syndrome.
  • Shift workers – Night shift work already disrupts circadian rhythms, which sertraline may compound.

If you fall into any of these high-risk groups, take extra care when starting sertraline and notify your doctor about any persistent sleepiness.

Will the Tiredness Go Away?

For most people, any sleepiness or fatigue caused by sertraline is mild and temporary. The body usually adjusts to the medication within a few weeks.

However, some individuals continue experiencing substantial drowsiness or energy loss. This may require adjusting the sertraline dosage or trying an alternative medication.

Here is a look at the time course of sleep-related side effects with sertraline:

First 1-2 Weeks

The most profound tiredness is usually noticed when first starting sertraline or after a dosage increase. This early sleepiness often gradually improves on its own within a couple weeks as the body acclimates.

First 1-3 Months

Sleep improvements like reduced insomnia and improved sleep quality may persist for the first few months. This can leave some individuals feeling like they need extra sleep during this period.

After 2+ Months

For those whose fatigue does not resolve after an initial adjustment period, the drowsiness may represent an ongoing side effect of treatment. Consulting with a doctor about adjusting medication may provide relief.

Overall, give sertraline at least 6-8 weeks before judging if the sleepiness or lack of energy represents a lasting side effect. It often diminishes over time or reverses after stopping the medication.

Tips for Managing Tiredness

If you experience persistent sleepiness, fatigue, or sedation while taking sertraline, there are some steps you can take to help manage these symptoms:

  • Talk to your doctor – They may adjust timing/dosage or prescribe a stimulant to counteract sedation.
  • Take sertraline at  – This can minimize daytime drowsiness. Take in the morning only if insomnia is an issue.
  • Avoid alcohol – Alcohol increases sedation and should be avoided when starting sertraline.
  • Reduce dosage – Lower doses may provide therapeutic benefit with less sedation.
  • Exercise and stay active – Regular exercise can boost energy and offset fatigue.
  • Maintain good sleep habits – Keep a consistent bedtime schedule and limit naps to manage drowsiness.
  • Consider caffeine – Caffeine blocks sleepiness but avoid excessive intake or afternoon use.
  • Improve diet – Eat a balanced diet and stay hydrated to nourish the body.
  • Treat underlying issues – Fatigue from sleep apnea, anemia, thyroid issues etc. requires a different approach.

The Bottom Line

Mild-to-moderate sleepiness is certainly possible when taking sertraline, especially in the initial weeks of treatment. However, fatigue and sedation seem to dissipate over time for most patients as the body adjusts.

If you continue suffering from substantial drowsiness, sleep problems, or low energy for more than 2 months, consult your doctor. They can provide personalized strategies to manage this side effect or explore alternative medication options.

While sertraline helps many by elevating mood and relieving anxiety, finding the right medication always requires some trial and error. Do not hesitate to be your own advocate if quality of life remains impaired by side effects like persistent fatigue.

With an attentive doctor and some patience in the adjustment period, most can find an optimal sertraline regimen that relieves symptoms without unwanted drowsiness


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