Sertraline Shows Early Symptom-Specific Benefits in Depression and Anxiety
RECENT research highlights that sertraline, a widely prescribed selective serotonin reuptake inhibitor (SSRI), may provide earlier relief for specific symptoms of depression and anxiety than previously recognised. Drawing from a large placebo-controlled randomized trial, investigators examined how sertraline affects individual symptoms and the interplay between them over time.
Sertraline’s Early Effects on Core Symptoms
When using traditional analytical methods, sertraline demonstrated beneficial effects on most depression and anxiety symptoms. However, a network analysis accounting for associations between symptoms revealed rapid improvements in core emotional and volitional symptoms of depression, such as sadness and negative self-perception, as early as 2 weeks into treatment. Anxiety symptoms across the board also showed early improvement. These results suggest that conventional summary scores, which aggregate symptoms, may obscure early, symptom-specific benefits of sertraline.
Somatic Effects May Mask Early Benefits
Interestingly, the study identified concurrent detrimental effects on somatic symptoms, including libido, appetite, and tiredness, which appeared around the same 2-week mark. Sleep and libido effects were observed at 6 weeks. These somatic side effects may temporarily offset improvements in mood-related symptoms when using overall depression scale scores, partially explaining why early antidepressant benefits are sometimes underappreciated.
No Change in Symptom Associations
Despite these direct effects, sertraline did not appear to alter the relationships between symptoms over time. In other words, while the drug alleviates sadness, worry, and other core symptoms, it does not disrupt the underlying associations or reinforcement cycles between them. This suggests that sertraline acts directly on specific symptoms rather than indirectly by changing symptom networks.
Implications for Clinical Practice
These findings emphasise the value of network-based analyses in evaluating antidepressant efficacy. By focusing on individual symptom trajectories, clinicians may better detect early improvements and differentiate between mood-related benefits and somatic side effects. Early detection of symptom-specific effects could inform patient monitoring and improve individualised treatment plans.
Overall, the study shows that sertraline exerts measurable benefits on both depression and anxiety symptoms within 2 weeks of treatment. While somatic side effects may mask these early improvements in traditional assessments, network analyses reveal the drug’s direct impact on core emotional symptoms, offering a nuanced view of antidepressant action in routine clinical populations.
Reference
Piazza GG et al. The effect of sertraline on networks of mood and anxiety symptoms: secondary analysis of the PANDA randomized controlled trial. Nat Mental Health. 2025; DOI:10.1038/s44220-025-00528-x.
