What is Sertraline (Zoloft)?
Sertraline, commonly known by the brand name Zoloft, is a prescription antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class of drugs [1.8.1]. It works by increasing the levels of serotonin, a chemical messenger in the brain that influences mood, sleep, and emotions [1.8.1]. Healthcare providers prescribe sertraline to treat a range of conditions, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD) [1.11.4]. By balancing serotonin levels, it aims to improve mood, reduce anxiety, and help individuals regain interest in daily life [1.8.3].
The Adjustment Period: Why You Might Feel 'Strange'
When starting sertraline, it's common to go through an adjustment period where you might feel worse before you feel better [1.8.1]. Many initial side effects, such as nausea, headache, fatigue, and trouble sleeping, often appear within the first week and typically subside within a few weeks as your body adapts to the medication [1.5.1, 1.5.4]. During this time, some people report feeling anxious, agitated, restless, or panicky [1.3.1]. These sudden changes in feelings can be unsettling and contribute to an overall sense of feeling 'strange' or not like yourself. It can take anywhere from 4 to 6 weeks to experience the full therapeutic benefits of sertraline [1.8.1].
Understanding Emotional Blunting
A significant psychological side effect associated with long-term sertraline use is 'emotional blunting' or numbness. Studies suggest that 40-60% of patients on SSRIs experience this, describing a reduced ability to feel both positive and negative emotions [1.4.1, 1.4.4]. Patients often report feeling emotionally dull, detached, or disconnected from their feelings and the world around them [1.11.1]. While this can dampen distressing emotions like sadness and anxiety, it can also diminish feelings of joy, love, and excitement, impacting relationships and overall quality of life [1.11.1]. Research has confirmed that this effect can be a direct result of the medication itself, not just an underlying symptom of depression [1.11.1].
Common and Serious Side Effects
Sertraline has a range of potential side effects, from mild and temporary to severe and requiring immediate medical attention.
Common Side Effects
These effects are often experienced early in treatment and may resolve over time [1.5.2, 1.5.4]:
- Nausea, diarrhea, or upset stomach [1.2.3]
- Headache [1.2.1]
- Dry mouth [1.3.5]
- Increased sweating [1.2.2]
- Dizziness and fatigue [1.2.1]
- Trouble sleeping (insomnia) or feeling sleepy [1.2.2]
- Changes in appetite or weight [1.3.5]
- Sexual problems, such as decreased libido or delayed ejaculation [1.2.2]
Serious Side Effects: When to Contact a Doctor
You should contact your healthcare provider immediately if you experience any of the following, as they can indicate a more serious condition [1.9.3, 1.9.4]:
- Suicidal thoughts or behavior: Especially in people 24 and younger during the first few months of treatment [1.2.4].
- Serotonin Syndrome: A life-threatening condition with symptoms like agitation, hallucinations, high fever, sweating, muscle stiffness, and a racing heartbeat [1.2.4].
- Manic Episodes: Symptoms include greatly increased energy, racing thoughts, reckless behavior, and excessive happiness or irritability [1.2.2].
- Abnormal Bleeding or Bruising: SSRIs can increase bleeding risk, especially if taken with NSAIDs like ibuprofen [1.2.4, 1.11.4].
- Seizures or Convulsions [1.2.4].
- Low Sodium Levels (Hyponatremia): Signs include headache, confusion, weakness, and feeling unsteady [1.7.2].
- Severe Allergic Reactions: Rash, hives, swelling of the face or throat, and difficulty breathing [1.9.1].
- Eye Pain or Vision Changes: May indicate angle-closure glaucoma [1.2.2].
Sertraline vs. Other Antidepressants: A Comparison
Sertraline's side effect profile is similar to other SSRIs, but there are some differences. The decision between medications often comes down to individual tolerance and the specific condition being treated.
| Feature | Sertraline (Zoloft) | Fluoxetine (Prozac) |
|---|---|---|
| Common Side Effects | More likely to cause gastrointestinal issues like diarrhea and nausea [1.6.1]. Higher reports of sexual dysfunction in men [1.6.1]. | More likely to cause headaches, nervousness, dry mouth, and sleep problems [1.6.1, 1.6.4]. |
| Approved Uses | MDD, OCD, PTSD, panic disorder, social anxiety disorder, PMDD [1.11.4]. | MDD, OCD, panic disorder, and bulimia [1.6.2]. |
| Tolerability | Some studies suggest sertraline may be better tolerated, with fewer patients discontinuing treatment due to side effects compared to fluoxetine [1.6.3]. | Effective, but some side effects like insomnia may be more pronounced [1.6.3]. |
Conclusion
So, can sertraline make you feel strange? Yes, it is possible. The initial adjustment period can bring about feelings of anxiety, restlessness, and other unusual sensations as your body adapts. Furthermore, long-term use can lead to emotional blunting for a significant number of users. Most common side effects are mild and temporary, but it is crucial to monitor for serious symptoms and maintain open communication with your healthcare provider [1.5.1]. Never stop taking sertraline abruptly without medical guidance, as this can cause withdrawal symptoms like dizziness, confusion, and electric-shock sensations [1.2.2]. If you are concerned about how sertraline is making you feel, discussing a dose adjustment or alternative medication with your doctor is the best course of action.
For more information, you can visit the National Alliance on Mental Illness (NAMI).
