Summary: The are some concerns over the long term effects of using sertraline but nothing is proven at this point. For example, there are reports of problems with coherent thought, sexual issues and weight gain. In general, these side effects lessen or disappear when the patient is weaned off the medication.
Dear Curtis: My brother has been taking sertraline for at least six or seven years. He lives in another state and I don’t see him a lot. But I’ve always been a little concerned about him being on a medication like that for that long. I thought antidepressants were suppose to be more of a short term thing? I’d just like to know what the long term effects of him being on Zoloft for that long might be?
We know sertraline can have side effects. But, when it comes to the long term side effects of antidepressants like sertraline I’m afraid there isn’t a lot of evidence or answers. There are concerns, which I’ll touch on. But at this point they are simply concerns and haven’t been proven one way or the other.
Also, some of the complaints that have been raised about sertraline seem to be dose-dependent as well. So, the higher the dose the more people seem to claim there are issues. Especially once someone is over 150mg a day (which, in my experience, isn’t very common).
The Heart of the Issue
I’ve actually known folks who have been on antidepressants for 15+ years. There’s nothing right or wrong about that, per say. What it comes down to is how a patient feels when they are on the medication. Obviously, if folks are taking a medication for that length of time it must be doing something for their mental well-being.
But, you bring up a good point about depression being a short-term thing.
In theory, it should be. Something in your life triggers depression. After time things generally get better and you get over it. But, that isn’t always the case. Some folks simply have a harder time getting over an issue. Some folks, truth be told, use the medications as a crutch.
Either way, we really don’t know what the effects of using these drugs long term is. But case studies and patient feedback have shown some trends:
Problems With Coherent Thought
I’ve read case reports and have had feedback from patients that claim to have trouble with lateral thoughts, following complex stories and, in general, feeling like they can’t keep up with any sort of complex task or conversation.
The best description I ever had for this was a patient feeling like their IQ has lowered a few points. I would like to note that many of these case reports claim this side effect on higher than normal doses of sertraline (150mg to 200mg a day).
This has also been described a number of different ways, but serotonin reuptake inhibitors (SSRI’s), like sertraline, have been linked to sexual difficulties. Most report focus around a lack of overall sex drive. Others, both men and women, report having a sex drive but unable to perform sexually (i.e., difficulty attaining and keeping an erection, difficulty becoming aroused, etc.).
Again, the long-term effects aren’t clearly understood.
While the early studies involving sertraline said it was fairly weight neutral (i.e., some patients would lose a pound or two, others may gain a pound or two) some patients did experience more significant weight gain. But this sometimes took over six months to a couple of years of treatment before it really cropped up. Weight gain, in some open label studies, was reported in 18% to 50% of the users (1).
Long Term Effects Vs. Side Effects
Frankly, what the overall long term effects on sertraline users, like your brother, might be are a different story than the side effects. If someone can wean themselves off of a drug like sertraline that they have been taking for years there is a good chance the side effects may disappear as well.
But the concern about what the long term effects will be on those patients isn’t known right now and probably won’t be for some time. I always advise folks so they clearly understand that these medications are changing and manipulating neurotransmitters in your brain. That can be good and bad. But, at the end of the day, it’s a fine and sometimes dangerous line to walk and you need to make sure that the reward of doing that outweighs the risk of the unknown – at this time – long term effects.
- Clinical Psychiatry News 26(5):1, 1998. © 1998 International Medical News Group. http://www.seroxatusergroup.org.uk/Long%20Term%20Side%20Effects.pdf