Does Sertraline Cause Dry Eyes? Understanding This Potential Side Effect

October 9, 2025 •

4 min read

According to research and clinical observations, sertraline, a selective serotonin reuptake inhibitor (SSRI), can occasionally cause dry eyes in some users. While typically mild, this ocular side effect occurs because the medication can interfere with the neurotransmitter pathways that regulate tear production.

Quick Summary

Sertraline, an SSRI antidepressant, is known to potentially cause dry eyes by altering neurotransmitter activity and affecting tear production. The side effect is usually mild and can often be managed with lifestyle adjustments and artificial tears. Consulting a healthcare provider is recommended for persistent symptoms.

Key Points

Sertraline can cause dry eyes: As an SSRI, sertraline can interfere with nerve signaling pathways that regulate tear production, leading to insufficient or unstable tear film.
The side effect is generally mild and temporary: Dry eye symptoms with sertraline typically affect a small percentage of users and often subside as the body adjusts to the medication.
Management includes simple strategies: Using lubricating eye drops, adjusting your environment with a humidifier, and practicing blinking exercises can provide significant relief from dry eye symptoms.
Do not stop medication abruptly: Never discontinue sertraline without consulting your prescribing doctor, as abrupt cessation can cause serious withdrawal effects.
Consult a healthcare professional for persistent symptoms: If dry eyes become severe or do not improve, it's important to discuss management options with your doctor or an eye care specialist, who may recommend a dosage adjustment or different medication.
Other medications also cause dry eyes: Other drugs, including antihistamines and some blood pressure medications, can also cause dry eyes, making it important to consider all medications you are taking.

The Connection Between Sertraline and Dry Eyes

Sertraline, commonly known by the brand name Zoloft, belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). While primarily used to treat depression, anxiety, and obsessive-compulsive disorder (OCD), it can sometimes produce side effects affecting the eyes, including blurred vision, pupil dilation, and dry eyes. The link between SSRIs and dry eyes is a documented phenomenon, as these drugs influence nervous system pathways that extend beyond the brain. A key insight from recent studies is the role of neurotransmitters, particularly serotonin, in ocular health. Serotonin receptors are present in eye tissues, and sertraline's effects on serotonin levels can therefore impact tear production and overall ocular comfort.

The Mechanism Behind Medication-Induced Dryness

The complex system of tear production is regulated by the autonomic nervous system. The parasympathetic nervous system, specifically, is responsible for stimulating tear secretion from the lacrimal glands. Medications with anticholinergic properties, which block a key neurotransmitter called acetylcholine, can disrupt this process and lead to significantly reduced tear production. While older tricyclic antidepressants (TCAs) have more potent anticholinergic effects, SSRIs like sertraline also interfere with nervous system signaling, albeit through different and often indirect pathways. Studies suggest that SSRIs can suppress the nerve signals that prompt the lacrimal glands to produce tears, compromising the aqueous (watery) layer of the tear film. There is also evidence suggesting that altered serotonin levels directly in the tear film may trigger inflammatory responses, further contributing to dry eye symptoms.

The Delicate Tear Film Balance

The tear film is comprised of three critical layers that work in harmony to protect and lubricate the eye:

The Aqueous Layer: The thick, watery middle layer produced by the lacrimal glands, which is responsible for washing away foreign particles and providing moisture. This is the layer most affected by SSRIs.
The Mucin Layer: The innermost layer, produced by goblet cells on the surface of the conjunctiva, which helps the tears adhere to the eye's surface.
The Lipid Layer: The oily outermost layer, produced by the meibomian glands, which prevents tear evaporation.

When sertraline or other antidepressants interfere with nerve signals, the delicate balance of these layers can be disrupted. This leads to either insufficient tear quantity (aqueous deficiency) or poor tear quality (evaporative dry eye), resulting in the characteristic gritty, burning, and itchy sensations associated with dry eyes.

Managing Dry Eye Symptoms from Sertraline

For most individuals, dry eye symptoms related to sertraline are manageable and often temporary. Here are some effective strategies:

Use Artificial Tears: Over-the-counter lubricating eye drops are often the first line of defense for mild symptoms. Preservative-free formulas may be better for those with sensitive eyes or for frequent use.
Adjust Your Environment: Use a humidifier to increase moisture in the air, especially in dry, air-conditioned, or heated environments. Avoid direct airflow from fans, vents, or hairdryers.
Practice Blinking Exercises: Prolonged screen time can reduce blinking frequency, worsening dry eye. Consciously blink more often and follow the 20-20-20 rule: every 20 minutes, look at an object 20 feet away for at least 20 seconds.
Maintain Eyelid Hygiene: Gently cleaning your eyelids can help prevent inflammation and ensure the proper functioning of the oil-producing meibomian glands.
Consider Dietary Changes: Some research suggests that a diet rich in omega-3 fatty acids, found in fatty fish, flaxseeds, and walnuts, may improve tear production.


Management Method	Description	Primary Mechanism of Action
Artificial Tears	Over-the-counter lubricating eye drops.	Replaces missing aqueous layer of the tear film.
Humidifier	Device that increases air moisture indoors.	Reduces environmental factors that cause tear evaporation.
Blinking Exercises	Consciously blinking more frequently.	Redistributes tears evenly across the eye's surface.
Eyelid Hygiene	Gentle cleansing of the eyelid area.	Supports meibomian gland function and tear film stability.
Omega-3 Supplements	Fatty acids from diet or supplements.	Supports tear film health and reduces inflammation.

How to Talk to Your Healthcare Provider

If dry eye symptoms are bothersome, it is crucial to speak with your doctor. Do not stop taking sertraline abruptly, as this can lead to serious withdrawal effects. Your healthcare provider can help you manage the side effects while maintaining the therapeutic benefits of the medication. During your consultation, be prepared to discuss your symptoms and how they affect your daily life. The doctor may suggest switching to a different antidepressant with a lower likelihood of causing dry eye, adjusting your dosage, or recommending a more targeted treatment plan. A comprehensive eye exam from an ophthalmologist or optometrist can also help rule out other potential causes of dry eye and assess the severity of the condition.

Conclusion

While sertraline is an effective treatment for many mental health conditions, it is a well-known potential cause of dry eyes. This side effect, which affects a small percentage of users, is due to the drug's influence on neurotransmitter pathways that regulate tear production. For most, the symptoms are mild and can be effectively managed with over-the-counter solutions, environmental changes, and lifestyle adjustments. However, open communication with both your prescribing doctor and an eye care professional is essential for finding the right balance between mental well-being and ocular comfort. By being aware of this potential side effect and knowing how to address it, you can navigate your treatment plan with greater peace of mind.

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Note: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional regarding any medical conditions or before making any decisions about your treatment or care.

Frequently Asked Questions

Dry eyes occur in a relatively small percentage of sertraline users, estimated to be between 4% and 7%. For most, the symptom is mild and temporary, often improving as the body gets used to the medication.

Sertraline affects neurotransmitter activity. Serotonin receptors are found in eye tissues, and sertraline can interfere with the nerve signals that stimulate the lacrimal glands, leading to reduced tear production and potential tear film instability.

Effective strategies include using over-the-counter artificial tears, making environmental adjustments like using a humidifier, practicing regular blinking exercises, and maintaining good eyelid hygiene.

No, you should never stop taking sertraline abruptly. It is crucial to talk to your prescribing doctor first, as sudden cessation can cause withdrawal symptoms. Your doctor can help you find a safe solution, such as adjusting your dose or exploring other treatment options.

For most people, dry eye symptoms from sertraline are temporary and improve with time or management. In some cases, if the issue is severe or prolonged, consulting an eye care professional is recommended for a tailored treatment plan.

Individuals who are older, have a pre-existing eye condition like dry eye or glaucoma, or take other medications that can cause dryness (e.g., antihistamines) may have a higher risk of experiencing dry eye symptoms.

Older tricyclic antidepressants (TCAs) have more potent anticholinergic effects, which directly block tear production. While sertraline and other SSRIs can cause dry eye, the mechanism is often more indirect and generally less pronounced compared to TCAs.