Does sertraline show up as a benzodiazepine on a drug test?
By
Ivan Kahwa
| Reviewed by
Ivan Kahwa
The contents of this article are fact-based except otherwise stated within the article.
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Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
Reviewer bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss whether sertraline shows up as a benzodiazepine on a drug test. We will also discuss why drug tests show false positives for controlled drugs and how Zoloft is different from benzodiazepines.
Does sertraline show up as a benzodiazepine on a drug test?
Yes, sertraline can show up as a benzodiazepine on a drug test. Although it is not that common, such cases have been reported.
Sertraline, a selective serotonin reuptake inhibitor, is primarily used as a prescription antidepressant and is not considered a controlled substance according to the Drug Enforcement Authority (DEA). (1,2)
Sertraline is not something expected to show up on a drug test, and standard 12-panel drug tests do not focus on this antidepressant as it’s not considered a drug of abuse.
However, sertraline can cause a false positive for benzodiazepines and can also rarely show up as lysergic acid diethylamide (LSD) (3). These potential false positives can be a matter of concern for people going for a drug test, and they may worry about failing it because of sertraline.
What does research suggest?
Several research studies have indicated that sertraline can show up as a benzodiazepine on a drug test. One research study specifically focused on the drug test results of those taking sertraline, with or without a benzodiazepine prescription (4).
522 cases were observed, and it was found that 26 cases of false positives for benzodiazepines were associated with the use of sertraline (4). This indicates that sertraline can potentially cause a false positive for benzodiazepines, and it could easily go unreported.
However, this research study also indicates that going for confirmatory tests like gas chromatography-mass spectrometry (GC-MS), which are more accurate and can narrow down the chances of false positives, could be a good approach in such cases (4).
Some research studies have also indicated that other SSRIs, like fluoxetine, may also cause false positives in some cases (5). However, the most common SSRI for showing up as a benzodiazepine is sertraline (5).
Additionally, some research studies have also indicated that apart from benzodiazepines, sertraline can also cause a false positive for LSD, another scheduled drug (3).
Is sertraline the same as benzodiazepines?
No, sertraline is not the same as benzodiazepines. These medications differ in their mechanisms of action, tolerability, and therapeutic efficacy. Sertraline, classified as a selective serotonin reuptake inhibitor (SSRI), works by increasing serotonin levels in the brain (1).
It is commonly used to treat depression and anxiety disorders. On the other hand, benzodiazepines act on the central nervous system to enhance the effects of a neurotransmitter called gamma-aminobutyric acid (GABA). They are often prescribed for conditions involving excessive excitability, like anxiety (6).
Benzodiazepines are classified as scheduled drugs due to their potential for abuse, tolerance, and dependence (6). This means they are more strictly regulated compared to sertraline.
Why do urine drug immunoassays cause false positives?
Urine drug immunoassays which are commonly used in standard panel drug tests can sometimes produce false positives, like sertraline showing up as a benzodiazepine, because of cross-reactivity (7). The principle behind urine drug tests involves detecting specific controlled substances or their metabolites.
Cross-reactivity occurs when the antibodies in the test react to a substance similar to the one it’s designed to react with. In the case of sertraline, which is an antidepressant, its chemical structure can trigger a response similar to benzodiazepines, leading to a false positive result for these drugs.
Cross-reactivity is not limited to prescription medications. Over-the-counter drugs, such as certain cold medicines or antihistamines, can also trigger false positives. These substances may share structural similarities with the targeted drugs in the test which can affect the results (8).
How to avoid getting a false positive while taking sertraline?
You might not be able to avoid getting a false positive for benzodiazepine while taking sertraline if you stick to urine immunoassays and can’t afford to go for more accurate but expensive procedures like GC-MS, but you can surely avoid the consequences (9).
The best way to deal with a drug test is to inform the testing authorities of all the prescription and over-the-counter medications that you are currently taking. As stated earlier, some over-the-counter medications, like cold and flu meds, can also sometimes show up on drug tests and make people fail them.
However, there is nothing to worry about if you’re just following your doctor’s directions and are not using the meds for abuse. Even controlled substances can be used as prescription medications, like amphetamines for the treatment of attention deficit hyperactivity disorder (ADHD).
So, it’s best to inform the authorities that you are currently taking sertraline, a drug that can potentially make you fail your test. If going for more accurate procedures is an option for you, you shouldn’t worry about getting false positives.
As a pharmacist, I have seen people worrying about getting false positives. I always advise my patients to inform the testing authorities about all the medications and supplements they currently take.
You can also submit your prescription as proof that you are indeed taking some prescription meds that can cause false positives. However, if you are using any prescription medication for abuse, it’s best to prioritise your health and rethink the choices you’ve been making.
There is a reason why they say ‘health is wealth,’ and there is nothing in the world that can make you feel better if your health starts deteriorating. So, take good care of your mental and physical health and consult with your provider if you’re concerned about anything.
References
- 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
- 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
- Alec Saitman, Hyung-Doo Park, Robert L. Fitzgerald, False-Positive Interferences of Common Urine Drug Screen Immunoassays: A Review, Journal of Analytical Toxicology, Volume 38, Issue 7, September 2014, Pages 387–396, https://doi.org/10.1093/jat/bku075
- Nasky KM, Cowan GL, Knittel DR. False-Positive Urine Screening for Benzodiazepines: An Association with Sertraline?: A Two-year Retrospective Chart Analysis. Psychiatry (Edgmont). 2009 Jul;6(7):36-9. PMID: 19724768; PMCID: PMC2728940. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728940/
- Callaghan, Katherine MD; Rappaport, David I. MD. False-Positive Urine Drug Screen for Benzodiazepines in a Child Taking Fluoxetine. Pediatric Emergency Care 37(5):p e283, May 2021. | DOI: 10.1097/PEC.0000000000002434 https://journals.lww.com/pec-online/citation/2021/05000/false_positive_urine_drug_screen_for.28.aspx
- Bounds CG, Nelson VL. Benzodiazepines. 2023 Jan 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29261973. https://www.ncbi.nlm.nih.gov/books/NBK470159
- Hughey JJ, Colby JM. Discovering Cross-Reactivity in Urine Drug Screening Immunoassays through Large-Scale Analysis of Electronic Health Records. Clin Chem. 2019 Dec;65(12):1522-1531. doi: 10.1373/clinchem.2019.305409. Epub 2019 Oct 2. PMID: 31578215; PMCID: PMC7055671. https://pubmed.ncbi.nlm.nih.gov/31578215/
- US Pharmacist. Urine Drug Screening: Minimizing False-Positives and False-Negatives to Optimize Patient Care, 2016;41(8):26-30. Available from: https://www.uspharmacist.com/article/urine-drug-screening-minimizing-false-positives-and-false-negatives-to-optimize-patient-care
- Ramoo B, Funke M, Frazee C, Garg U. Comprehensive Urine Drug Screen by Gas Chromatography/Mass Spectrometry (GC/MS). Methods Mol Biol. 2016;1383:125-31. doi: 10.1007/978-1-4939-3252-8_15. PMID: 26660182. https://pubmed.ncbi.nlm.nih.gov/26660182/