Urgent 'do not eat fruit' warning issued to people who take Sertraline

Millions of people who take a common medication are being issued an important message about one fruit they urgently need to avoid. The latest data reveals that more than 24 million sertraline prescriptions were filled in England in 2024, making it the top prescribed antidepressant in the country.

While sertraline is among the most frequently used antidepressants in the UK, this number reflects the total prescriptions rather than the actual count of people using the medication. Sertraline is a type of antidepressant, created to help treat clinical several mental health conditions.

Those included are depression, obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD). Sertraline is part of a group of medicines known as selective serotonin reuptake inhibitors (SSRIs).

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The NHS says: "Sertraline works by increasing the levels of a mood-enhancing chemical called serotonin in your brain. It helps many people recover from depression, and has fewer unwanted side effects than older antidepressants. Sertraline comes as tablets, which are available only on prescription."

Antidepressants can help with mental health symptoms, but they often don't tackle the underlying root cause. That's why they're usually paired with therapy, especially for more serious cases of depression or other mental health problems. The side effects of antidepressants can be hard to adjust to at first, but they generally get better as time goes on.

Common side effects of sertraline:

• Feeling sick (nausea)
• Headaches
• Being unable to sleep
• Feeling sleepy
• Diarrhoea
• Dry mouth
• Feeling dizzy
• Feeling tired or weak

What fruit should people on sertraline avoid?

One kind of fruit can make these side effects worse and mess with how well the medication works. Grapefruit and its juice can boost the levels of certain antidepressants in your body, which might lead to some nasty side effects.

A statement on the NHS website reads: "Do not drink grapefruit juice while you're taking this medicine. Grapefruit juice can increase the amount of sertraline in your body and increase the risk of side effects."

It's best to steer clear of grapefruit while taking antidepressants unless your doctor says it's okay. The reason grapefruit messes with antidepressants is that it blocks an enzyme called CYP3A4 - which is in your small intestine and liver - that helps break down medications.

It also slows down how the medication is processed, which leads to more sertraline building up in your bloodstream. When sertraline levels are higher, you're more likely to face side effects or even toxicity.

Higher doses of sertraline might cause risky alterations in heart rhythm. Some possible dangers are kidney harm, muscle injury, and breathing issues. Even milder side effects can get worse, like a faster heart rate, elevated blood pressure, headaches, feeling dizzy, and stomach discomfort.

Seville oranges, pomelos, and limes can interact in similar ways. Just skipping grapefruit while taking the medication isn't enough; you need to steer clear of grapefruit for the whole time you're on the medication.

What other medication does grapefruit impact?

Besides sertraline, other antidepressants that interact with grapefruit include fluoxetine (Prozac), fluvoxamine (Luvox), amitriptyline (Elavil), and trazodone (Desyrel). There are many other medications that grapefruit negatively interacts with, including:

• Statins, such as atorvastatin and simvastatin.
• Blood pressure medications, such as felodipine, nifedipine, and amlodipine.
• Anti-anxiety drugs, including buspirone.
• Immunosuppressants, such as cyclosporine.
• Heart Rhythm drugs, such as amiodarone and disopyramide.
• Antihistamines, such as the non-drowsy allergy medication fexofenadine.

While grapefruit has many health benefits, if you're taking this medication, the risks might be more significant than the benefits. It's a good idea to chat with your doctor or pharmacist before starting any new prescription, especially if you have any worries or questions.

You might want to check if your new medication interacts with certain foods or other drugs to ensure you're not putting your health at risk. If there are any interactions, be sure to ask if you need to change your diet or how you take your other medications.