One of the most prescribed antidepressants in the UK. The first two weeks are the hardest and nobody warns people enough.
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Sertraline is an SSRI — a selective serotonin reuptake inhibitor. It increases the amount of serotonin available between nerve cells in the brain.
The honest position on how antidepressants work is that the serotonin explanation is a simplification and the full mechanism is not settled. What is well established is that for moderate to severe depression and for several anxiety disorders, they work better than placebo in trials, and they help a great many people.
Once daily, at the same time each day. Morning suits most people; if it makes you drowsy, take it at night.
With or without food, though taking it with food reduces early nausea.
It does not work immediately. Expect little in the first two weeks, some improvement by four, and the fuller effect by six to eight. A great many people stop at day ten concluding it does not work, which is roughly the point at which the side effects are at their worst and the benefit has not yet arrived.
Never stop it abruptly. Coming off needs a gradual taper over weeks or months, planned with a clinician.
The first one to two weeks are usually the worst part, and knowing that in advance is the single biggest predictor of getting through them.
Common early effects: nausea, headache, dry mouth, disturbed sleep, and — importantly — a temporary increase in anxiety or agitation. Most settle.
Sexual side effects are common and under-discussed. Reduced libido, delayed orgasm and erectile difficulty affect a substantial proportion of people. This is worth raising rather than enduring, because dose changes and alternatives exist.
Longer term: sweating, weight change, and emotional blunting — a sense of feeling flattened rather than better — which is a legitimate reason to review the drug.
Important safety warning: in people under 25, SSRIs carry a small increased risk of suicidal thoughts and self-harm in the early weeks. Anyone starting one needs close monitoring during that period, and this age group should be reviewed within a week or two.
Seek urgent help for agitation with fever, tremor and confusion — rarely, serotonin syndrome.
Care is needed in pregnancy and breastfeeding — not a blanket prohibition, but a genuine risk-benefit discussion, and untreated depression in pregnancy carries its own risks.
Bleeding risk increases when SSRIs are combined with NSAIDs, aspirin, warfarin or DOACs. Stomach protection is often added.
Other interactions: triptans for migraine, tramadol, St John's Wort (which people frequently do not mention because it is herbal), lithium, and other serotonergic drugs.
Sodium can fall, particularly in older people — worth checking if someone becomes confused or unsteady after starting.
Thyroid function is worth checking before starting, because an underactive thyroid produces symptoms indistinguishable from depression.
Yes, where clinically appropriate, and mental health assesses well by video — a 20-minute appointment allows a proper conversation in a way a ten-minute one does not.
What that involves: a full assessment including risk, a discussion of whether medication, talking therapy or both is the right route, bloods where a physical cause is possible, and — crucially — planned follow-up in the first few weeks, which is when things can briefly feel worse.
Where we will not manage remotely: severe depression with significant risk, psychosis, bipolar disorder, or anyone under 18 starting an antidepressant. These need in-person specialist care and we will help you get there rather than prescribe.
If you need help now, do not wait for an appointment. Call 999 or go to A&E if you are in immediate danger, 111 for urgent advice, or Samaritans free on 116 123 at any hour.
This page is information, not an offer to supply.
Sertraline is cheap. It is long off patent, and the generic is what everyone gets — there is no branded version worth paying for.
On a private prescription the drug cost plus dispensing fee is usually less than the England NHS prescription charge of around £10. NHS prescriptions are free in Wales.
It is therapy — and the best version of it is free. NHS Talking Therapies takes self-referrals without a GP appointment, and CBT has strong evidence in both depression and anxiety.
We would rather point you there than sell you something. Private therapy is worth paying for when the NHS wait where you live is long, or when you need a specific modality that is not offered locally.
Sertraline is not addictive — there is no craving and no dose escalation — but stopping it abruptly causes discontinuation symptoms, and those are real.
Dizziness, "brain zaps", nausea, irritability, vivid dreams and flu-like aching typically begin within a few days of stopping and can be mistaken for the original illness returning. That distinction matters, because it changes what you do next.
Between SSRIs this is usually straightforward and often done directly. Moving to or from certain other antidepressants requires a washout to avoid serotonin syndrome, and should never be improvised.
Do not stop and start on your own — that pattern produces most of the bad experiences people report.
On average, yes — but modestly, slowly, and less than most other antidepressants.
Sertraline is among the more weight-neutral SSRIs. Studies following people for a year or more show an average gain in the region of one to two kilograms, most of it after the first six months. That is an average across many people: a substantial number gain nothing, and some lose weight, particularly early on when nausea is common.
Separating the drug from the illness is the harder question. Depression itself changes appetite in both directions. Someone who was barely eating and starts eating normally again will gain weight — and that is recovery, not a side effect. Someone whose low mood drove comfort eating may find it settles. The tablet gets blamed for both.
What to do if it is happening:
The drugs to be more concerned about are amitriptyline and mirtazapine, where weight gain is pronounced and often the main reason people stop. If weight is a significant concern for you, that is a reasonable thing to factor into the choice at the outset.
No. There is no craving and no need for increasing doses.
It does cause discontinuation symptoms if stopped suddenly, which is a genuinely different thing and the reason it is tapered. That distinction is often explained badly, and it puts people off unnecessarily.
Four to six weeks for a proper effect, sometimes longer.
The first two weeks can feel worse — more anxious, more restless, poorer sleep. Knowing that in advance is the difference between pushing through and stopping on day ten.
It should not. The aim is to feel like yourself again, not flattened.
Emotional blunting — feeling neither low nor particularly anything — does happen, and it is a reason to adjust the dose or switch rather than something to accept indefinitely.
Common, under-discussed, and worth raising. Reduced desire, difficulty reaching orgasm and delayed ejaculation all occur.
They usually improve on a lower dose or a different drug. Most people are never told to expect them, which makes them harder to attribute.
Small amounts are usually tolerated, but alcohol works against the treatment. It is a depressant, it worsens sleep, and it amplifies the drowsiness.
Heavy drinking while starting an antidepressant is genuinely counterproductive.
Usually not. A first episode is typically treated for six to twelve months after recovery, then reduced.
Recurrent episodes may warrant longer, and that is a decision to make deliberately rather than by drift.
At least six months after you feel well. Stopping the moment things improve is the single commonest cause of relapse.
No. Combining them risks serotonin syndrome, which can be serious.
Tell any prescriber about every supplement, not just prescribed medicines.
No — we do not prescribe benzodiazepines or z-drugs for ongoing use, and we never start them remotely.
They cause dependence quickly and undermine the treatments that work. For sleep, we would address the sleep problem itself.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 24, 2026
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Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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