Is Sertraline Safe? Exploring Effectiveness, Safety, and 5 Things to Avoid When Taking Sertraline

With over three decades of experience in anxiety treatment, one of the common questions I get is “is sertraline safe?” I can attest to the generally safe and effective nature of sertraline for most individuals over extended periods. As a selective serotonin reuptake inhibitor (SSRI), sertraline has proven its efficacy in alleviating anxiety symptoms.

While the majority of patients experience its benefits without significant issues, a subset may encounter sexual side effects like reduced libido or difficulties in achieving and maintaining erections. It’s crucial to foster open communication with your healthcare provider to address any concerns promptly.

Persistent side effects, even after discontinuation, are rare but possible. In navigating anxiety treatment, a collaborative approach with your doctor ensures a personalized and balanced strategy, promoting both mental health and overall well-being.


Quick Summary

  • Sertraline is generally safe for long-term use and effective in treating anxiety.
  • Some individuals may experience suicidal or sexual side effects, such as lower libido or difficulties with erections.
  • Persistent side effects are rare but should be discussed with a healthcare provider for proper guidance and adjustment of treatment if necessary.
Is Sertraline Safe?

Is Sertraline Safe?

Sertraline is generally considered a safe and well-tolerated medication for long-term use; however, certain safety concerns should be carefully addressed. Higher doses of sertraline increase the likelihood of toxic effects, emphasizing the importance of precise dosing under medical supervision.

Sexual side effects, including difficulties with erection or lower libido, can occur, as well as an increased risk of suicidal thoughts—particularly at the onset of treatment or when adjusting the dosage. Notably, these sexual side effects may persist even after discontinuing the medication, warranting a proactive discussion with your healthcare provider.

It is crucial to be aware of potential complications and interactions. Sertraline can induce dizziness or drowsiness, cautioning against engaging in activities requiring mental alertness until individual tolerance is established.

Additionally, a serious heart problem may arise, with a higher risk if the patient is concurrently using specific medications for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Moreover, prior health conditions, such as bipolar disorder, heart disease, liver or kidney disease, seizures, glaucoma, bleeding problems, and a history of low sodium levels, should be disclosed to the doctor to ensure a thorough assessment of the medication’s safety for the individual.

Who should avoid sertraline?

Personalized assessments and discussions with a medical professional are essential to determine the most suitable treatment approach based on individual health conditions and potential risks. The following individuals should avoid sertraline:

1. Individuals with a History of Allergic Reactions

If you have ever had an allergic reaction to sertraline or any other medication, it is advisable to avoid sertraline. Allergic reactions can manifest in various ways, ranging from mild skin irritation to severe systemic responses. Individuals with a known sensitivity to sertraline or related substances should explore alternative treatment options under the guidance of their healthcare provider.

2. Those with Heart Conditions

Individuals with pre-existing heart problems should exercise caution when considering sertraline. The medication can potentially accelerate the heart rate or lead to irregular heartbeats (arrhythmias). Before starting sertraline, individuals with a history of heart conditions should undergo a thorough cardiac evaluation to assess the risk-benefit profile and explore alternative treatments if necessary.

3. Pregnancy, Breastfeeding, or Attempting to Conceive

If you are currently pregnant, attempting to get pregnant, or breastfeeding, the use of sertraline should be approached with caution. The potential impact of sertraline on fetal development is a critical consideration, and its use during pregnancy or breastfeeding should only be undertaken after careful consultation with a healthcare professional. Alternative treatments or adjustments to the treatment plan may be explored based on individual circumstances.

4. Individuals with Glaucoma

Sertraline has the potential to increase intraocular pressure, making it unsuitable for individuals with glaucoma. Elevated eye pressure can exacerbate the condition and lead to further complications. If you have glaucoma or a history of increased eye pressure, it is essential to inform your healthcare provider to explore alternative medications that do not pose a risk to your ocular health.

5. Those with Epilepsy or Undergoing Electroconvulsive Treatment

Individuals with epilepsy or those undergoing electroconvulsive treatment should exercise caution with sertraline. The medication may elevate the risk of seizures or fits, necessitating careful consideration and potential adjustments to the treatment plan. Alternative medications that are safer for individuals with a history of seizures may be explored under the guidance of a healthcare professional.

What should I avoid taking sertraline?

You should avoid grapefruit juice, moderate alcohol intake, and abstain from stimulants, hallucinogens, and novel psychoactive substances are crucial steps to ensure the safety and efficacy of sertraline treatment. Always consult with a healthcare provider to discuss any concerns or questions related to medication interactions. These are the details:

1. Grapefruit Juice Interaction

Consuming grapefruit juice while taking sertraline is not advisable. Grapefruit juice is among the foods to avoid when taking Zoloft since it can interfere with the metabolism of sertraline, leading to an increased concentration of the medication in the body.

What to avoid when taking Sertraline: Grape fruit

This elevation in sertraline levels raises the risk of side effects, potentially intensifying the medication’s impact and causing adverse reactions. It is crucial to avoid grapefruit juice during sertraline treatment to maintain the appropriate balance of the medication in the body.

2. Alcohol Consumption

While it is generally permissible to drink alcohol while taking sertraline, it is important to exercise caution. Alcohol can enhance the sedative effects of sertraline, potentially causing increased drowsiness or fatigue.

Individuals taking sertraline should be mindful of their alcohol consumption and consider limiting or abstaining until they understand how the medication affects them. Open communication with healthcare providers is key to managing the potential interaction between sertraline and alcohol.

3. Stimulants such as MDMA (Ecstasy) or Cocaine

The use of stimulants like MDMA (ecstasy) or cocaine in conjunction with sertraline poses significant risks. Sertraline may interact with these substances, potentially amplifying their effects or leading to unpredictable reactions.

Combining sertraline with stimulants can have adverse consequences on both mental and physical health, including an increased risk of serotonin syndrome—a potentially life-threatening condition. It is crucial to avoid the concurrent use of sertraline and stimulant drugs.

4. Hallucinogens like LSD

Using hallucinogenic substances like LSD while on sertraline can lead to unpredictable and potentially harmful interactions. Sertraline affects serotonin levels in the brain, and combining it with hallucinogens may intensify psychedelic experiences or result in adverse reactions.

The combination may also increase the risk of serotonin syndrome. Individuals taking sertraline should avoid the use of hallucinogens to ensure the stability and predictability of their mental health treatment.

5. Novel Psychoactive Substances (NPS)

The consumption of novel psychoactive substances, formerly known as legal highs, like mephedrone, should be avoided in tandem with sertraline. These substances often have unpredictable effects on the central nervous system, and combining them with sertraline can lead to heightened risks.

The potential for adverse reactions, including increased anxiety, hallucinations, or cardiovascular complications, underscores the importance of abstaining from the use of novel psychoactive substances during sertraline treatment.


Sertraline is generally considered safe for the majority of individuals, providing effective relief for anxiety and mood disorders. With over three decades of clinical experience, it has demonstrated its efficacy in managing these conditions. However, caution is advised, as some individuals may experience sexual side effects, such as lowered libido or difficulties with erections.

Additionally, there are potential risks associated with specific health conditions, like heart problems, and interactions with certain substances, such as grapefruit juice and illicit drugs. As with any medication, individual responses vary, necessitating open communication with healthcare providers to tailor treatment plans and ensure the overall safety and well-being of the patient.

Dr. David Barlow

David is a well-known researcher and author in the anxiety disorders area with extensive research on their etiology, nature, and treatment. He started the site to share his real-life experiences on the management of anxiety disorders with successful diagnosis and treatment being his motivation to write or review the content on this site.