Does sertraline work the second time around? (9+ side effects) 

In this article, we will discuss whether sertraline works the second time around. We will also talk about the reasons that may lead to sertraline discontinuation and why people may start to take it again. We will also discuss what one should do if sertraline does not work the second time around.

Does sertraline work the second time around?

Sertraline may or may not work the second time around, depending on the reason that led to drug discontinuation in the first place. Sertraline is one of the most commonly prescribed antidepressants worldwide and is well-tolerated (1,2). 

However, some people may discontinue this antidepressant due to various reasons. A small percentage of these people may begin to use sertraline again and could get concerned about whether it will work the way it used to. 

Recent surveys have indicated that sertraline can work when people start to take it again after discontinuing it. However, they may need a dose escalation or a dose higher than the one they last took. 

This is because antidepressants take time to work, but once they kick in and you continue to take these meds, your body may become used to them. 

When you start taking that exact same dose after having some days off, your body might not respond well to it, and you may end up needing a higher dose to generate an adequate therapeutic response. 

The reason for sertraline discontinuation is also quite important, as many people quit taking sertraline because of side effects. This is a different situation, and those side effects will come back once you restart taking sertraline. 

It is best to reach out to your doctor if you think you need sertraline again. If you’re experiencing depression relapse and wish to start taking it again, sertraline can work and help you with your symptoms. Your doctor will adjust your dose accordingly to ensure that you receive a safe and effective therapeutic response.

What factors lead to sertraline discontinuation?

Several factors can lead to sertraline discontinuation, including:

Depression/anxiety remission

When individuals experience remission of their depressive or anxiety symptoms while on sertraline, their doctors may decide to taper the medication off. 

The goal of antidepressant treatment is often symptom relief, and if someone achieves stability and improved mental health, some people might not need ongoing sertraline therapy. This can lead to drug discontinuation.

Side effects

Side effects play a significant role in the decision to discontinue sertraline. Some individuals may find that the side effects, which can range from mild to severe, outweigh the benefits of the medication (3). 

Common side effects like nausea, insomnia, or sexual dysfunction can affect a person’s quality of life and lead to a decision to stop the medication. 

Inefficacy

It is a known fact that people are different and can respond differently to antidepressants. For some individuals, sertraline may not effectively manage their symptoms. 

In such cases where the antidepressant proves ineffective in managing depression or anxiety, healthcare providers may consider alternative treatment options and recommend discontinuation of the current medication.

Switching to a better antidepressant

Sometimes, individuals discontinue sertraline not due to the side effects or inefficacy, but because of the availability of a better antidepressant for their symptoms. Some people may want to explore alternative antidepressants that might offer a more favourable balance of efficacy and tolerability.

Why do some people start retaking sertraline?

Some people may start to retake sertraline after discontinuing it if their symptoms return. This usually happens with people who stop sertraline because of the remission of symptoms, and after drug withdrawal, such people may begin to fall back into depression. 

In such cases, doctors may advise restarting the antidepressant and giving the body more time to heal. Some people may discontinue sertraline because of inefficacy and may get switched to another medication. 

Determining the best antidepressant could be a trial-and-error process, and people may try multiple antidepressants before they find the one that works best for them. 

Such people may not do well on new antidepressants, and their doctors may advise switching back to sertraline with proper dose adjustment, an additional antidepressant, or behavioural therapy to give their treatment plan another chance to work. 

Sometimes, taking sertraline a second time around works more effectively than the first try. However, it varies hugely from person to person, as people are different and can respond differently to medications.

What side effects are common when taking sertraline for the second time?

When trying sertraline for the second time, some individuals may experience common side effects that are often temporary and can occur as the body adjusts to the medication. These side effects can include feelings of nausea, vomiting, diarrhoea, etc.

However, these side effects might not be so pronounced as your body already knows how sertraline makes it feel. It is important to note that some people may restart taking sertraline at a higher dose than they used to take. This can increase the risk of side effects, including: (1,3)

• Trouble sleeping
• Changes in appetite
• Weight changes
• Increased anxiety or restlessness
• Fatigue
• Dry mouth
• Blurred vision
• Headache
• Dizziness
• Sweating
• Sexual problems
• Tremors or shaking
• Upset stomach

It’s important to remember that these side effects usually improve over time as your body gets used to the medication. If you find the side effects troublesome or if they persist, it’s important to talk to your doctor.

What to do if sertraline does not work the second time around?

If sertraline does not work the second time around and you do not observe any positive changes in your symptoms, please reach out to your healthcare provider. Your doctor will consider alternative treatment strategies, as there are plenty of other antidepressants that can replace sertraline. 

Your doctor will evaluate your symptoms and determine the best possible alternative. The symptoms one is experiencing play an important role in determining the best antidepressant. 

For example, if a person is struggling with depression comorbid with insomnia, their doctor might recommend a sedative antidepressant such as trazodone or mirtazapine to manage both symptoms. 

Similarly, someone who is sleeping excessively due to depression shouldn’t take these sedative antidepressants, and meds like Wellbutrin, Prozac, etc., might be better for them, as these drugs can manage fatigue and increase energy levels. 

So, determining the best antidepressant is directly linked to the symptoms one is experiencing. However, it’s not your choice to make, and you should rely on your doctor’s expertise to come up with the most suitable antidepressant for your needs. 

It is important not to change your antidepressant, dosage strength, or how often you take it without consulting your doctor first.

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