Sertraline Diarrhea: What It Is, Why It Happens, and What to Do

When you start taking sertraline, a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety, and other mood disorders. Also known as Zoloft, it works by increasing serotonin in the brain—but serotonin doesn’t just live in the brain. It’s also found in your gut, where it helps control bowel movements. That’s why sertraline diarrhea is one of the most common side effects people report in the first few weeks.

It’s not rare. Studies show up to 20% of people on sertraline experience loose stools or more frequent bowel movements early on. This isn’t an allergic reaction or food poisoning—it’s your body adjusting to higher serotonin levels in the intestines. The gut has more serotonin receptors than the brain, so when sertraline blocks serotonin reabsorption, the extra serotonin speeds up digestion. Think of it like hitting the gas pedal on your digestive system. Most people find the diarrhea eases after 1–4 weeks as their body adapts. But if it sticks around, gets worse, or leads to dehydration, it’s not something to ignore.

Some people try to fix it by cutting the dose, switching meds, or using over-the-counter anti-diarrheals like loperamide. But that’s not always the best move. Stopping sertraline suddenly can cause withdrawal symptoms like dizziness, nausea, or mood swings. Instead, try simple fixes first: eat smaller meals, avoid spicy or fatty foods, stay hydrated, and add soluble fiber like oats or bananas. Probiotics may help too—some research suggests certain strains can ease SSRI-related gut issues. If it’s still a problem after a month, talk to your doctor. They might suggest switching to another SSRI like escitalopram, which tends to cause less diarrhea, or adding a low-dose anti-nausea med like ondansetron, which also works on gut serotonin.

It’s worth noting that not everyone gets this side effect. Some people take sertraline for years without a single stomach upset. But if you’re one of the ones who does, you’re not alone—and you don’t have to just live with it. The good news? This side effect is usually temporary, manageable, and doesn’t mean the drug isn’t working. In fact, many people find their mood improves just as the diarrhea fades.

Below, you’ll find real-world guides from people who’ve been through this exact issue. Some share how they adjusted their diet. Others talk about timing their pills with food, or how they worked with their doctor to tweak the dose. You’ll also see comparisons between sertraline and other antidepressants when it comes to gut side effects. No fluff. No guesses. Just practical steps from those who’ve been there.

Medicine

Managing Sertraline Nausea and Diarrhea: Practical Tips & Strategies

Learn why sertraline often triggers nausea and diarrhea, how common these issues are, and practical steps to manage them without stopping the medication.

Read