What Are the Different Sertraline Interactions?

Sertraline is a medication that belongs to the family of drugs known as selective serotonin reuptake inhibitors (SSRIs). Like other SSRIs, sertraline is used to treat mood and anxiety disorders. This medication can sometimes interact with certain drugs and supplements taken at the same time. These sertraline interactions can be harmful, so the doctor prescribing this medication should be made aware of any other medications a patient is taking.

Some of the most potentially dangerous sertraline interactions can occur with another class of drugs used to treat depression, known as monoamine oxidase inhibitors (MAOIs). MAOIs can increase the effect of sertraline to the point that harmful events occur. This danger can persist for weeks after an MAOI has been taken, so a doctor must be made aware of any MAOIs taken within the past five weeks before taking sertraline or other SSRIs.

This medication affects levels of the neurotransmitter serotonin. Other medications that increase serotonin, ranging from medications like tramadol and dextromethorphan to the compound commonly referred to as "ecstasy" (methylenedioxymethamphetamine), may cause harmful sertraline interactions. Adverse effects can include serotonin syndrome, a rare but possibly life-threatening condition.

Antidepressants can cause drowsiness in some individuals. Sometimes, there may be sertraline interactions that increase this drowsiness when combined with drugs that have a similar sleep-inducing effect. These compounds include alcohol, central nervous system (CNS) depressants like anti-anxiety drugs, and opioid pain relievers like codeine. Sleeping pills and some allergy medications like diphenhydramine may cause excessive drowsiness as well.

Certain medications may lead to sertraline interactions that increase the risk of bleeding. Aspirin works to prevent clotting among blood cells, and this effect can increase when taken with sertraline. Such an effect can occur even with low, therapeutic doses of aspirin.

Other medications that impact blood clotting, such as non-steroidal anti-inflammatory drugs (NSAIDs) may also increase bleeding risks. Blood thinning medications like warfarin or heparin may cause similar effects. Clopidogrel, used in the treatment of some heart conditions, may increase the risk of bruising or bleeding following slight injuries.

Drugs that impact sertraline's ability to bind to plasma proteins in the bloodstream can lead to harmful effects, as well. Digitoxin, for example, may compete with this SSRI for plasma protein space, and one or the other medication may be displaced. This may cause harmful effects as excess levels of one medication are made available to affect the body. Extreme caution should be used when taking sertraline with other drugs that strongly bind plasma proteins.