Does Sertraline Cause Insomnia? Tiredness, Dreams, Headaches and What Helps (UK)

Can sertraline cause insomnia? What the NHS and leaflet say

Yes. Sertraline is an SSRI antidepressant, and the NHS lists “problems sleeping” and “dizziness or drowsiness” among its common side effects. The UK leaflet is more specific and puts insomnia, sleepiness and fatigue in its very common group, which means they may affect more than 1 in 10 people.

The leaflet also describes akathisia: a distressing restlessness and need to keep moving, most likely in the first few weeks. It can make it hard to settle at night. Tell your doctor if you get it, because the leaflet says increasing the dose may be harmful.

Sertraline is used for depression, OCD, panic disorder, PTSD and social anxiety disorder. For whether it’s a good choice for anxiety, see is sertraline good for anxiety?

Does sertraline make you tired?

It can. Fatigue and sleepiness are both very common in the leaflet, and the NHS lists drowsiness. Some people sleep badly on sertraline and feel tired the next day; others feel drowsy in the day even after a full night. Both often settle as your body gets used to it.

The NHS says if you feel dizzy or drowsy after taking sertraline, don’t drive, ride a bike or use machinery until you no longer have these symptoms. Low mood, anxiety and stress can disturb sleep in their own right, so tiredness isn’t always the tablet. For other causes, see why am I always tired?, and for a similar SSRI, does fluoxetine make you tired?

How long does sertraline insomnia last?

Often a couple of weeks. The NHS says most side effects should ease after a couple of weeks as your body gets used to the medicine, but some can last longer. Sertraline itself takes time to help: the leaflet says it may take several weeks before your symptoms begin to improve.

iThe NHS says your doctor may start you on a low dose and increase it after a week or more, so you may notice sleep problems again for a short time after a dose change. If poor sleep is still affecting daily life after a few weeks, speak to your doctor rather than waiting it out.

Should I take sertraline in the morning or at night?

Either is fine according to the NHS, which says take sertraline once a day at the same time, either in the morning or evening. If it keeps you awake, ask your pharmacist or prescriber whether taking it in the morning would suit you better. If it makes you drowsy in the day, ask whether the evening would suit you better.

Change the time with their advice rather than on your own, and then keep to the new time each day. If you miss a dose, the NHS says skip it and take your next dose the next day as usual. Never take 2 doses to make up for a missed one.

Can sertraline cause vivid dreams or nightmares?

Yes. The leaflet lists nightmares as common (up to 1 in 10 people) and terrifying abnormal dreams as rare. Teeth grinding is also common, which can leave you with a sore jaw or a morning headache. Like other side effects, dreams often settle with time.

iIf nightmares are wrecking your sleep, tell your doctor. See vivid dreams, teeth grinding and, if you wake in the small hours, why do I wake up at 3am?

Can sertraline cause headaches?

Yes. A UK sertraline leaflet lists headache as very common, meaning it may affect more than 1 in 10 people, and the NHS lists headaches among the common side effects. Like most sertraline side effects, headaches often ease in the first couple of weeks. Speak to a pharmacist or your doctor if they bother you or don’t go away.

Ask a pharmacist which painkiller to use: the NHS lists NSAIDs such as ibuprofen and aspirin among the medicines that may not mix well with sertraline, and the leaflet says they can raise the risk of bleeding. The leaflet also lists a sudden severe headache as a rare side effect. The NHS says call 999 or go to A&E for a headache that started suddenly and is extremely painful, or comes with confusion, weakness or trouble speaking.

For other headache causes, see what your headache location can mean and tension headaches.

Sertraline and alcohol

The NHS says it’s best not to drink alcohol while taking sertraline because it can stop the medicine working properly, and the leaflet says alcohol should be avoided. Alcohol also adds to drowsiness and can disturb your sleep. See alcohol and sleep.

What helps you sleep on sertraline

1. Talk to a pharmacist or your doctor. They can look at the timing or dose. If you’ve just started, ask a pharmacist about the New Medicine Service.
2. Keep taking it unless you’re advised to stop (see below).
3. Get up at the same time every day. The NHS insomnia advice is to keep a regular wake time, avoid caffeine, alcohol and nicotine for several hours before bed, and skip daytime naps.
4. Wind down for about an hour before bed, for example with a bath or a book. See sleep hygiene.
5. Don’t lie there for hours. If you wake in the night, see middle insomnia and how to stay asleep.
6. Ask about CBT for insomnia if poor sleep lasts for months. The NHS says GPs generally avoid sleeping pills except for short periods. See insomnia.

Should I stop sertraline if I can’t sleep?

No, not on your own. The NHS says don’t suddenly stop taking sertraline because it may cause withdrawal symptoms; your doctor will reduce the dose gradually over several weeks or months. The leaflet lists sleep disturbances, dizziness, numbness, agitation and anxiety among the effects of stopping, so stopping suddenly can make sleep worse, not better.

Your doctor can change the dose, the timing or the medicine if sleep problems don’t settle.

When to get urgent help

The leaflet says thoughts of harming yourself may be more likely when you first start an antidepressant, and to contact your doctor or go to a hospital straight away if you have them. You can report side effects through the MHRA Yellow Card scheme.

Supplements and CBD with sertraline: check first

No supplement treats sertraline side effects. The NHS says don’t use St John’s wort with sertraline, and to tell your doctor about any herbal remedies, vitamins or supplements. The leaflet says talk to your doctor before taking products with tryptophan, so check before tryptophan or 5-HTP, and it says not to take sertraline with grapefruit juice. For ashwagandha, see ashwagandha side effects.

CBD: don’t take CBD alongside sertraline or other SSRIs without asking your GP or pharmacist first. CBD can interact with some medicines, and drowsiness can add up. The FSA advises people taking any medication not to take CBD unless under medical direction. See can CBD interact with medication?

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Our Reishi Mushroom Adaptogenic Complex isn’t suggested here: its pack says it isn’t for people on medication. For more on magnesium and sleepiness, see does magnesium make you sleepy?

iIf you take any regular medicines, check with your GP or pharmacist first. We don’t recommend our products during pregnancy or breastfeeding. For adults (18+) only.