Does sertraline suppress the immune system? (3+ research studies)

In this article, we will discuss whether sertraline suppresses your immune system. We will discuss some research studies and the general link between depression and the immune system. We will also discuss what one should do if sertraline affects their immune system. 

Does sertraline suppress the immune system?

Sertraline may suppress the immune system in some individuals. It is not frequently reported, but sertraline is effective with some symptoms linked to autoimmune disorders. This indicates that this antidepressant can suppress immuno-mediators to some extent (1). 

However, it is important to note that people are different and have different factors affecting their health. Someone with an underlying immunological disorder could be more susceptible to sertraline-induced immunological changes. 

The drug itself may not cause significant changes, but it can suppress your immunity to some extent. It’s best to discuss your concerns about the immune system before starting sertraline.

What does research suggest?

Several research studies have discussed the potential effects of SSRIs, including sertraline, on the immune system and its primary mediators – cytokines. 

One research study indicated that depression – the condition for which sertraline is primarily used – is linked to immune hyperactivity (1). These changes might go unnoticed, but depression itself can affect immune responses or trigger a response (1). 

Sertraline, being an antidepressant, can reduce depression, which in turn can reduce immune hyperactivity (1,2). This study also indicated that sertraline and other SSRIs might normalise your immune functions, instead of suppressing them. 

Another research study indicated that sertraline can directly affect the functioning of immune cells (3). Sertraline decreased the proliferation of lymphocytes – the type of white blood cells primarily involved in generating immune responses (3). 

Furthermore, the study also showed that sertraline can reduce the secretion of cytokines responsible for mediating immune responses – thus suppressing the immune system. Sertraline also significantly reduced TNFα (Tumor necrosis factor-α) secretion (3).

Another research study investigated the effects of sertraline on COVID-19 patients (4). The study showed the anti-inflammatory effects of sertraline on the participants, and immunoregulation was also reported (4). 

However, one research study did not show any effects of sertraline on the immune system in HIV-positive patients (5). 

What is the link between depression and immunity?

There is a definitive link between depression and the immune system. Research studies have shown that depressed individuals usually have increased cytokine activity and may have inflammation in their brains (6). 

This indicates that depression itself can trigger immune responses. However, the severity of the mental health illness is an important factor, and not every depressed individual has a highly active immune system.

What factors can affect your immune system while taking sertraline?

Some factors can affect your immune system while taking sertraline, including: 

  • Individuals with pre-existing autoimmune disorders may experience more pronounced immunosuppressive effects when using sertraline. 
  • In cases where individuals have an existing immunological deficiency unrelated to sertraline use, the medication may exacerbate the effects.
  • Some medications, when taken with sertraline, can have immunomodulatory effects.
  • Patient-specific factors and an individual’s genetic makeup can also influence immunity while being treated with sertraline.

What to do if sertraline affects your immune system?

If you think sertraline is negatively affecting your immune system, please reach out to your doctor. Patient education is important, and you should know how sertraline is affecting your body and your normal physiology. 

Although sertraline is not associated with affecting immunity significantly or making you prone to infections, people are different and can respond differently to medications. 

If you have other comorbidities that can affect your immune system or if you are taking any other medication concomitantly with sertraline that can affect immune mediators, you should discuss the safety of sertraline use with your doctor. 

In my personal experience, I have never come across a patient who experienced immunosuppressive effects of sertraline to a point where it starts affecting the normal body physiology. I have actually seen some positive immune responses, especially in the case of individuals with pre-existing autoimmune disorders. 

So, it’s safe to say that sertraline does not dangerously suppress your immunity, but it can tone down immune responses to some extent, which can be beneficial for certain individuals. It’s always best to discuss your concerns with your provider and learn basic things about your current treatment regimen.

References 

  1. Szałach ŁP, Lisowska KA, Cubała WJ. The Influence of Antidepressants on the Immune System. Arch Immunol Ther Exp (Warsz). 2019 Jun;67(3):143-151. doi: 10.1007/s00005-019-00543-8. Epub 2019 Apr 29. PMID: 31032529; PMCID: PMC6509093. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509093/ 
  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
  1. Gobin, V., Van Steendam, K., Denys, D., & Deforce, D. (2014). Selective serotonin reuptake inhibitors as a novel class of immunosuppressants. International Immunopharmacology, 20(1), 148-156. https://doi.org/10.1016/j.intimp.2014.02.030 
  1. Hamed MGM, Hagag RS. The possible immunoregulatory and anti-inflammatory effects of selective serotonin reuptake inhibitors in coronavirus disease patients. Med Hypotheses. 2020 Nov;144:110140. doi: 10.1016/j.mehy.2020.110140. Epub 2020 Jul 26. PMID: 32768893; PMCID: PMC7382922. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382922/ 
  1. Rabkin JG, Wagner G, Rabkin R. Effects of sertraline on mood and immune status in patients with major depression and HIV illness: an open trial. J Clin Psychiatry. 1994 Oct;55(10):433-9. PMID: 7961520. https://pubmed.ncbi.nlm.nih.gov/7961520/ 
  1. Karaoulanis SE, Angelopoulos NV. [The role of immune system in depression]. Psychiatriki. 2010 Jan;21(1):17-30. Greek, Modern. PMID: 22214869. https://pubmed.ncbi.nlm.nih.gov/22214869/#:~:text=Patients%20diagnosed%20with%20depression%20tend,corticosteroids%20during%20the%20stress%20response

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