The side-effects nobody tells you about – nausea, issues sleeping, and weight gain
Sertraline, or known by its alternative brand name Lustral, is an anti-depressant classed as a SSRI – which means it increases the levels of serotonin (the happy hormone) by repressing your bodies’ ability to absorb it, meaning you’re happier for longer. I’ve been taking it since October when I was diagnosed with a ‘major depressive episode’ – the medical term for ‘wow she needs a bit of help’.
My GP started me on 25mg a day, and after a few weeks this was upped to 50mg a day, which I take with my breakfast first thing. It took about four weeks to kick in, but I can safely say that my mood is far better than last year where I was feeling on edge and ready to cry at any second. I now feel able to get up (well, on most days anyway) and take out the rubbish and do all those small household things that I was failing hopelessly to do in the depths of my depression.
Now, whilst for the most part I feel better in myself, there are some side effects which I was not aware of before being started on the tablet. The ones that have had an impact on me? Problems sleeping, strange issues with my eyesight, nausea, and weight gain. All of these have slightly offset the good that I think sertraline has done for me and I really wish I’d known about them and considered how those might also impact my health before starting on them.
This wasn’t my first rodeo.
I’ve taken anti-depressants before, a round in 2009 when illness and deadlines fell on top of me and I couldn’t cope. Another in 2011 when I was struggling with a toxic relationship, and feeling unsafe at work – a place where I was bullied by one partner and sexually assaulted by another. I don’t think these things were the underlying cause, but they certainly didn’t help.
I had a small amount of therapy both times, and it helped me realise that what I was feeling was okay, it was justified. In 2014, after being on the waiting list for 2 years, I was referred for a year of psycho-therapy, where I explored a range of problems rooted in my childhood. I’ve come to realise that I don’t trust easily, and I expect others to understand me without having to tell them what I need. I’m not good at setting boundaries or asking for what I need. I don’t understand how to be close to people. And I’ve spent the last few years tackling the things that came out of that, trying to grow myself into a better human but examine who I want to keep around me and make sure I want them to be around me.
The anti-depressants I was prescribed both of these times were not SSRIs, and they made me feel completely numb and switched off; it was like I was in a dream. I lost all the sparkle in my character and time flowed past without me really appreciating it. I drank a lot, and relied on the alcohol to let me come alive – but, as anyone with sense will tell you, alcohol isn’t the answer. I ended up in perilous situations, and my openness and dumbed-down senses left me open and vulnerable. I made friends who ended up to be the very opposite of friends – I was assaulted in my own home on numerous occasions by people I’d been foolish enough to trust. Now? I rarely drink. If I do, it’s around people I love. If you’ve seen me throw back a few drinks, then you should know it’s because I felt safe around you.
Last year, when I was prescribed anti-depressants, I was so nervous. I didn’t want to turn back into that zombie who felt nothing. But it turns out that over the past few years, GPs have increasingly been prescribing SSRIs, and for good reason – they don’t numb your senses like the older medicines do, and by increasing the level of serotonin available, you are left feeling happier. And it works!
However, as with any medicine, there are side-effects. I’ll talk through the ones that have had an impact on me.
Apparently this is normal to experience within the first 4-6 weeks, but holy heck I was not expecting it. It was just constantly feeling like I was going to throw up after every meal, and dry-heaving between meals. I had no idea what was wrong with me, and for a few days thought I had mild food poisoning – until I spoke to my GP who said it was perfectly normal to feel a bit sick, and to try taking my tablets with food. I take them with breakfast now, but I still feel a little bit sick occasionally. So much for 4-6 weeks.
Possible issues with eyesight.
Coincidentally, I started getting slightly blurry vision at the edges of my eyesight about the same time I started to take sertraline. My optician can’t find any evidence of retinal damage or glaucoma, and she’s stumped. The only thing we can see that has changed is taking these tablets – which, it turns out, have been linked to eye pressure problems. The main issue I have is rings of light in the periphery of my left eye, which isn’t a huge issue, but it does catch my eye at night and it’s more off-putting than anything else.
This one has a huge impact on me. One sign that I’m struggling with depression is that my sleep gets out of control; I develop insomnia over a number of days and crash on the fourth or fifth day and sleep for sometimes 14-16 hours. With the tablets though, my sleep is even more disturbed. Sertraline can cause insomnia, but it can also cause hypersomnia, sleeping too much or feeling really sleepy, and I feel like I have both. I take my tablet in the morning in the hope that it won’t prevent me from being able to get to sleep but I still find that I am regularly lying awake at 3am. It isn’t just not being able to sleep; I constantly feel fatigued and too lethargic to do anything. The past couple of weeks I’ve had to have a nap after work because I feel so exhausted. Perhaps it’s the lack of sleep at night, but taking naps has also meant that it’s harder to sleep at night. I am in a constant state of tiredness, and it has been about 6 months since I last woke up in the morning feeling refreshed and ready to tackle the day. Every single morning is a struggle, and I reckon I could easily sleep for 12-14 hours every single night – if I could get to sleep in the first place.
If the fatigue and lethargy wasn’t enough, I also get migraines – which I suspect are linked to lack of sleep. Brilliant.
I’m trying all sorts of things. I’m limiting screen time, but that doesn’t seem to help too much. I’m trying to not eat too late so I’m not digesting in bed – which is okay for the most part, although I do have binge-eating disorder which means that sometimes I don’t manage it. I’ve found one thing that does help – a white noise machine, which helps drown out the sound of sirens or random clicks and noises that disturb me as I’m trying to get to sleep. I’m a light sleeper, so these things tend to startle me awake again as I doze off. If you’re struggling with sleep, I do recommend trying a white noise machine and see if it works for you too!
Oh man, I had NO IDEA about this one. I’ve dug around for some research and one study suggested a third of people taking sertaline put on AT LEAST 10lbs whilst taking it. Isn’t that mad?
And for me? I’ve put on nearly 30lbs. THIRTY.
Yep. And that’s over just 6 months, and it isn’t because I’ve been totally overindulging. I mean, I have BED but I’ve had that for a while and my weight had pretty much plateaued. It started with me putting on my favourite dress – to find that it just didn’t sit right. My boobs just…didn’t seem to fit. And suddenly they were bursting out of my bras; it was like I’d put a cup size on overnight.
And then I noticed that my hips are more rounded, and my tighter clothes were straining to contain them. My tummy is bigger, more pronounced, more pouch-like. And my body dysmorphia went into overdrive – picking and pinching every piece of my to examine how the weight gain was affecting my body. Larger arms, a visible second chin poking through, bigger thighs. I could keep going, but I’m not going to, because I feel so torn about it.
“But you should feel comfortable with you at any size, don’t let your BDD trick you” says one part of my brain. “But look at these beautiful clothes you can’t fit into anymore, and look how uncomfortable you feel” says the other half. And both sides of my brain are right – I wish, I really do, that I could be comfortable with myself at any size, but the truth is that I can’t. I was just getting used to the idea of my body minus the extra 30lbs, but now? I can’t shake it the inner judgement. The sadness that I can’t wear a huge wardrobe of gorgeous dresses. The fact that I am running out of things that feel comfortable to throw on. I’m worried that people have noticed the weight gain as it has been so drastic, so fast.
I’d love to be able to write something about coming to terms with my body for how it is, and how I’m okay with these extra 30lbs, but I have to be honest – I am not okay with it. And of all the side-effects, this is the one that is messing with my mind and undoing some of the good that the tablets are doing. It stings inside every time Instagram reminds me of pictures from two years ago, wearing clothes that I haven’t a hope in hell of being able to fit into at the moment.
This isn’t a ‘woe is me’ post either – I’m just sharing where I’m at. Because ultimately, you might be reading this because you’re curious what might be going on for me, but also, you might be going through a bad patch yourself. Perhaps you’ve been prescribed Sertraline or Lustral and are interested to know what the side effects are like. If so, I would encourage you stick with the tablets as they really do help clear away that depressive fog – but be aware that there are some side effects that might impact you and your recovery.
Resources and other useful links.
Find out more about Sertraline: Sertraline (NHS)
Explore depression: Mind, the mental health charity
Struggling with your mental health? There is help out there! : Mind helplines
Read more about my mental health journey : I used to have a woman in my wardrobe (and other ways to cope with chronic depression)