What to do if sertraline causes diarrhoea? (5+ tips that help)
By
Ivan Kahwa
| Reviewed by
Ivan Kahwa
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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
What to do if sertraline causes diarrhoea?
If sertraline causes diarrhoea, there are a few things that can help:
- Talk to your doctor
- Take antidiarrheal medications
- Drink plenty of water
- Try oral rehydration solutions (ORS)
- Take probiotics
- Eat a bland diet
Talk to your doctor
If sertraline causes diarrhoea, it’s best to report it to your healthcare provider. Diarrhoea is considered one of the common early side effects of sertraline, and people do report nausea, vomiting, loose motion, stomach cramps, etc (1,2).
These side effects are usually expected to get better with time, but they can make people suffer while they last. So, talking to your doctor about your side effects can help, as your doctor may adjust your dose to help your body adjust to it.
Dose reduction is quite helpful, especially for people new to Zoloft or whose dose has recently been increased. This can reduce the intensity of your diarrhoea. However, sertraline may not work well for everyone.
If Zoloft is not the right choice of antidepressant and continues to affect your stomach, your doctor will consider alternative treatment options. Make sure you keep your prescription the same.
Take antidiarrheal medications
You can also take antidiarrheal medications, such as Imodium (loperamide). It does not necessarily interact with Zoloft but can cause some side effects in certain individuals (3).
If you’re experiencing severe diarrhoea while taking sertraline, it’s best to reach out to your doctor or pharmacist to make sure that you take those medications which are compatible with the antidepressant and with any pre-existing health condition you might have. This ensures your safety and alleviates your symptoms effectively.
Drink plenty of water
It is crucial to stay hydrated while experiencing diarrhoea; this condition excessively removes water from your body and can cause severe dehydration. Vomiting associated with diarrhoea also causes water loss (4).
This dehydration can dangerously reduce blood volume, cause low blood pressure, and induce weakness. So it is necessary to drink plenty of water and fluids in general to ensure that your body has enough hydration for normal physiological functioning.
Try oral rehydration solutions (ORS)
It is also important to include oral rehydration solutions (ORS) in your diet if you’re experiencing severe diarrhoea (5). These solutions contain electrolytes, which your body also loses along with water.
This can also affect your blood pressure and cause muscle weakness and body pain. So, it’s important to ensure that you’re not getting electrolyte deficient and drink plenty of hydrating fluids.
Take probiotics
Probiotics are also essential if you’re experiencing diarrhoea. Probiotics containing Lactobacillus acidophilus can prevent and manage diarrhoea to some extent. Research suggests that taking probiotics can speed up the recovery process and improve digestion (6).
You can look for a probiotic supplement that contains multiple strains, including those from the Lactobacillus and Bifidobacterium genera. Different strains may have varied effects on gut health.
The typical duration for taking probiotics in medication-induced diarrhoea can vary from person to person, depending on the severity. However, most doctors suggest taking probiotics 2-3 times a day for 3-5 days.
Eat a bland diet
What you’re eating while suffering from diarrhoea can make it better or worse. Eating spicy or heavy foods can aggravate your symptoms, and no matter how many medications you are taking, it will significantly slow down your recovery.
So it is crucial to stick to a diet that is light on your stomach and easy for you to digest. Some diarrhoea-friendly dietary suggestions are: (7)
| Food options | Details |
| BRAT diet | Bananas: Easily digestible, and provide potassium. |
| Rice: Helps bind stools and provides energy | |
| Applesauce: Gentle on the stomach, a source of pectin. | |
| Toast (plain): Low in fibre, easy to digest. | |
| Low-fibre foods | Boiled or steamed white rice: Easily digestible. |
| Boiled or baked chicken (skinless): Lean protein. | |
| Plain crackers or dry toast: Low-fibre options. | |
| Probiotic foods | Plain yoghurt with live cultures: Introduces beneficial bacteria for gut health. |
| Binding foods | Cooked carrots: Low-fibre, helps absorb excess water in the intestines. |
| Baked potatoes (without skin): Easily digestible, binding. | |
| Low-fat proteins | Baked or grilled fish: Lean protein, easy to digest |
| Skinless, boiled chicken or turkey: Lean protein source. | |
| Clear Liquids | Clear broth (chicken or vegetable): Hydrating and provides electrolytes |
| Clear fruit juices (apple, grape): Gentle on the stomach. | |
| Coconut water: Natural source of electrolytes. | |
| Weak tea: Non-caffeinated, soothing. |
What to do if sertraline-induced diarrhoea persists?
If sertraline-induced diarrhoea persists, it is important to talk to your doctor about this. These side effects, as stated earlier, should go away once your body adjusts to the medication. However, sertraline does not work for everyone.
If you’re persistently experiencing negative effects on this antidepressant, your doctor will consider alternative treatment options. However, you shouldn’t make any changes to your prescription on your own.
Sertraline-induced gastrointestinal side effects
Sertraline-induced gastrointestinal (GI) side effects are quite common. In my experience as a pharmacist, I have come across many people who reported nausea, GI upset, stomach pain, indigestion, gas, acid reflux, and several other GI side effects while taking sertraline.
However, most of these cases improve once the body adjusts to the antidepressant. Sertraline can affect serotonin levels, which are involved in various physiological and psychological functions.
Serotonin also has receptors in the gut, which explains why people experience GI side effects on this antidepressant. However, it is important to note that people are different and respond differently to medications.
It’s best to keep an eye on your side effects and report anything that concerns you to your healthcare provider.
References
- 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
- 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
- Sahi N, Nguyen R, Santos C. Loperamide. 2023 Mar 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491808. https://www.ncbi.nlm.nih.gov/books/NBK557885
- Cutting WA. Mechanisms of diarrhoea and why they matter. Dialogue Diarrhoea. 1988 Dec;(35):4-5. PMID: 12281645. https://pubmed.ncbi.nlm.nih.gov/12281645/
- Cutting WA, Langmuir AD. Oral rehydration in diarrhoea: applied pathophysiology. Trans R Soc Trop Med Hyg. 1980;74(1):30-5. doi: 10.1016/0035-9203(80)90007-3. PMID: 7434417. https://pubmed.ncbi.nlm.nih.gov/7434417/
- IQWiG (Institute for Quality and Efficiency in Health Care). Bookshelf ID: NBK373095. Can probiotics help against diarrhoea? Available from: https://www.ncbi.nlm.nih.gov/books/NBK373095/
- Nemeth V, Pfleghaar N. Diarrhea. 2022 Nov 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28846339. https://www.ncbi.nlm.nih.gov/books/NBK448082/#:~:text=A%20bland%20’BRAT’%20diet%20including,reduce%20the%20frequency%20 of%20 stools.