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Subjects/Psychiatry/SSRIs
SSRIs
medium
brain Psychiatry

A 28-year-old male starts sertraline for generalized anxiety disorder. He reports significant nausea, diarrhea, and stomach upset during the first week of treatment. Which of the following is the most likely explanation for these symptoms?

A. A. Serotonin syndrome
B. B. Hypersensitivity reaction
C. C. Common initial side effect of SSRIs
D. D. Drug-induced pancreatitis

Explanation

Gastrointestinal side effects such as nausea, diarrhea, and dyspepsia are very common initial side effects of Selective Serotonin Reuptake Inhibitors (SSRIs) like sertraline. These symptoms are thought to be due to the presence of serotonin receptors in the gut and the acute increase in serotonin levels. They typically occur within the first few days to weeks of starting treatment and often subside as the body adjusts to the medication. Serotonin syndrome involves a broader constellation of symptoms including mental status changes, autonomic hyperactivity, and neuromuscular abnormalities, which are not fully described here. Hypersensitivity reactions usually involve rash, fever, or other allergic manifestations. Drug-induced pancreatitis is a rare and severe adverse effect, not typically presenting as common initial GI upset.

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