Maria asked
Zoloft (sertraline) and insomnia... how common is this and when does it go away? I fall asleep easily but wake between 3 and 5 every night (and can’t fall back asleep) leaving me sleep deprived. My psych doctor says it’s a side effect so will not give me anything for it.
At a glance
- Yes, Zoloft (sertraline) can cause insomnia.
- Per the prescribing information for the drug, the incidence rate is around 16% (meaning 16% of individuals will experience the side effect)
Answer
Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) that is most commonly used to treat depression and anxiety disorders.
Zoloft, and all SSRI drugs, are associated with several commonly occurring side effects, which include:
- Nausea/Vomiting
- Activation/insomnia
- Sexual dysfunction
- Neurological effects (e.g. exacerbate headaches, anxiety)
- Increased risk of falls
- Weight fluctuations
Most studies note that all medications in the SSRI class have comparable tolerability and side effects.
Nevertheless, they all have varying pharmacokinetic profiles (e.g. metabolism, drug interactions, etc...) which can influence how a particular medication is tolerated.
Zoloft And Insomnia
According to the prescribing information for Zoloft (sertraline), insomnia occurs in 16% of individuals taking the medication and it appears to be dose-related (meaning higher doses increase the risk of the side effect occurring).
Related side effects include:
- Tremor (11% incidence)
- Agitation (6% incidence)
- Psychomotor hyperactivity (<2% incidence)
If you are experiencing side effects from Zoloft, initial strategies generally do not include the addition of medication to mitigate them.
More commonly, the initial strategies include:
- Take Zoloft early in the morning, as opposed to the evening.
- Lower the dose.
If the above strategies are not effective, it may be necessary to add on a sleep medication, such as melatonin or a prescription sedative-hypnotic. Additionally, following good sleep hygiene practices can be effective.
In many cases, side effects tend to be most pronounced when therapy is first initiated or when doses are increased but they tend to decrease over time.
Nevertheless, if issues with insomnia continue to occur, even after changing administration time, lowering the dose or adding on adjudicative medication, it may be beneficial to switch to another antidepressant (within the same class or to another class).
It is important to let your doctor know of any side effects you are experiencing and discuss a treatment plan that includes what to do if your problems with insomnia do not subside.
Information About Zoloft
Zoloft (sertraline) (pronounced SER tra leen) is FDA approved to treat:
- Depression
- Obsessive-Compulsive Disorder (OCD)
- Panic Disorder
- Post-Traumatic Stress Disorder (PTSD)
- Premenstrual Dysphoric Disorder (PMDD)
- Social Phobia
Zoloft is classified as a selective serotonin reuptake inhibitor (SSRI) and works by increasing the availability of serotonin in the brain as well as changing the balance of serotonin receptors.
Zoloft may be taken without regard to meals in the morning or evening. Like many antidepressants, full effects of the drug may not be realized until you have been on it for at least 6-8 weeks.
Final Words
Insomnia is a common side effect of Zoloft. There are several strategies that can be utilized to mitigate the side effect but for some individuals, it may not be able to be completely eliminated.
If this is the case in your situation, talk to your doctor regarding your options.
