Based on NIH | Is fatigue a common side effect of sertraline, and does it typically improve over time?

Yes fatigue (tiredness/sleepiness) is a commonly reported side effect of sertraline, especially in the first few weeks, and it often improves as your body adjusts over time. ^{[1] [2]} Many people notice that these early effects lessen with continued use, and ongoing treatment is frequently better tolerated than the initial period. ^[3] In clinical experience and trials with SSRIs, sleepiness and fatigue are among the most frequently mentioned early complaints, though they do not affect everyone. ^[4]

What to Expect Early On

• Common early side effects: sleepiness, trouble sleeping, dizziness, headache, nausea, and dry mouth are frequently noted when starting an SSRI like sertraline. ^[2] These effects are often mild to moderate and tend to fade as the nervous system adapts. ^[3] General drug information resources also list “tiredness” among the possible side effects of sertraline. ^[5]

• Time course: Many SSRI side effects improve within the first 1–3 weeks as your body adjusts, and longer‑term use is typically better tolerated with side effect rates approaching placebo in continuation phases of treatment. ^[3] In longer studies of sertraline, side effect reporting after several weeks became similar to placebo, supporting the idea that tolerability improves over time. ^[6]

How Common Is Fatigue With Sertraline?

• Frequency: Sleepiness/fatigue is commonly reported across SSRIs in real‑world surveys and is among the most frequent complaints, alongside sexual side effects and weight change. ^[4] Product labeling and official drug compendia include fatigue as a listed adverse event for SSRIs. ^[7] While published fixed‑dose data for other SSRIs show a dose‑response for fatigue and somnolence, the general SSRI class pattern suggests that higher doses may be associated with more sedation‑type effects. ^[8]

Practical Ways to Manage Fatigue

• Adjust timing: If drowsiness is prominent and your prescriber agrees, taking sertraline in the evening can be considered, as long as it doesn’t worsen insomnia. ^[2]
• Short naps and activity: A brief daytime nap and light physical activity (like a walk) can help counter fatigue. ^[9]
• Avoid risk when drowsy: Try not to drive or operate machinery until you know how sertraline affects your alertness. ^[9]
• Allow time for adaptation: Because many side effects improve with continued use, monitoring for a few weeks before making changes is often reasonable, unless symptoms are severe. ^[3]

When to Talk to Your Clinician

• Persistent or worsening fatigue: If sleepiness does not improve after the early adjustment period or disrupts daily function, discuss options such as dose timing, dose adjustments, or considering an alternative antidepressant. ^[3]
• Other symptoms: If fatigue is accompanied by concerning symptoms (e.g., profound lethargy, confusion, or other unusual effects), seek medical advice promptly, since sertraline can cause a range of side effects and individual responses vary. ^[5]

Bottom Line

• Common but usually temporary: Fatigue and sleepiness are common early side effects with sertraline, and they often lessen over the first few weeks as your body adapts. ^{[2] [3]}
• Manageable: Simple strategies like adjusting dose timing and adding light activity can help, and many people tolerate the medication better with time. ^[9]
• Stay in touch with your clinician: If fatigue remains troublesome, there are safe, step‑wise adjustments your clinician can suggest to improve tolerability without sacrificing antidepressant benefit. ^[3]