Does sertraline cause fidgeting? (3+ factors involved)

In this article, we will discuss whether sertraline causes fidgeting. We will also discuss some research studies, the potential causes of fidgeting while taking this antidepressant, and what one can do about it.

Does sertraline cause fidgeting?

Sertraline can cause fidgeting during the early course of your treatment. Sertraline is a commonly prescribed selective serotonin reuptake inhibitor used for the management and treatment of depression, anxiety, and several other mental health conditions (1,2). 

Fidgeting refers to small movements of the hands and feet, and it is one of the most common symptoms of anxiety itself. Sertraline may also cause anxiety as an early side effect, and fidgeting and jitteriness are common in some people (3). 

However, these side effects are considered temporary and do start to subside as your body adjusts to the antidepressant. If you find yourself fidgeting uncontrollably while taking sertraline, please reach out to your healthcare provider.

What does research suggest?

Research has linked symptoms like fidgeting and jitteriness with the use of sertraline. One case study involved a patient who experienced severe jitteriness, anxiety, fidgeting, restlessness, and aggressiveness just after taking a low dose of sertraline (4). 

While it’s not common for every individual to experience these side effects intensely, some people do report increased anxiety during the early course of treatment (4). This suggests that sertraline can trigger such symptoms, more severely in some people than in others. 

Some research studies have also indicated that sertraline and other SSRIs can cause extrapyramidal side effects, which may include abnormal or uncontrolled movement of the limbs (5). 

Based on these studies, fidgeting could be a mild and temporary side effect of sertraline, which might be more common in people who also tend to do it out of habit. However, it can also be a serious side effect of sertraline, although uncommon.

How does sertraline cause fidgeting?

Sertraline can cause fidgeting by affecting the excitatory neurotransmitters in your brain. As an SSRI, sertraline inhibits the reuptake of serotonin by blocking serotonin transporters (SERT). (1)

Serotonin is primarily involved in the pathophysiology of depression, and balancing this chemical is a major approach to managing these mental health conditions (1). However, during the early course of treatment, sertraline can cause anxiety, jitteriness, and fidgeting due to increased serotonergic activity. 

This alteration in your brain chemistry may take time to produce positive changes, and individuals might feel uneasy initially. 

Nevertheless, it’s a known fact that your condition tends to improve as the antidepressant takes effect, and these side effects usually diminish with time. If, for some reason, your fidgeting persists, please reach out to your healthcare provider.

What other factors can contribute to fidgeting while taking sertraline?

Some other factors can contribute to fidgeting while taking sertraline, including:

These factors can vary from person to person and each individual is unique. It’s best to discuss these factors with your provider to ensure whether sertraline is the best choice of antidepressant for your symptoms.

What to do if sertraline causes fidgeting?

If sertraline is causing fidgeting, it’s crucial to reach out to your healthcare provider. Your doctor will assess whether this side effect will improve over time or if there are other underlying factors contributing to it. 

In certain cases, especially if you’re new to sertraline or have recently increased your dose, opting for a dose reduction may be a suitable option. This allows your body to adjust to the medication. 

If you respond well to a lower dose, your doctor may consider retrying dose escalation after a week or two to assess your body’s tolerance to a higher dose.

However, it’s important to recognise that dose reduction may not be effective for everyone. Additionally, some individuals may experience severe anxiety and depression that may not improve with sertraline monotherapy. 

If sertraline isn’t sufficiently alleviating your anxiety and fidgeting is presenting as a symptom of your mental health condition rather than a side effect, your doctor may adjust your dose or explore alternative interventions. 

A combination of antidepressants may be considered if necessary, or there might be a more suitable medication to manage your symptoms. 

As a pharmacist, I always advise adhering to the prescribed medication and dose. Any necessary changes to your treatment plan should be made under the guidance of your healthcare provider, and you should never make adjustments on your own.

References 

1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689
   
2. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf

3. National Library of Medicine. Sertraline: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https://medlineplus.gov/druginfo/meds/a697048.html

4. Nakamura T, Sugiyama N, Sasayama D, Hagiwara T, Washizuka S. Jitteriness/Anxiety Syndrome Developing Immediately following Initiation of Oral Administration of Sertraline. Case Rep Psychiatry. 2017;2017:1319505. doi: 10.1155/2017/1319505. Epub 2017 Aug 22. PMID: 28912994; PMCID: PMC5585583. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585583/ 

5. Lambert MT, Trutia C, Petty F. Extrapyramidal adverse effects associated with sertraline. Prog Neuropsychopharmacol Biol Psychiatry. 1998 Jul;22(5):741-8. doi: 10.1016/s0278-5846(98)00036-0. PMID: 9723116. https://pubmed.ncbi.nlm.nih.gov/9723116/