A tragic incident highlights the serious risks associated with widely prescribed antidepressants, as a grandmother, Grace Uludag, died from an accidental overdose of sertraline. The 55-year-old from Kent was found with high levels of the drug in her bloodstream when she passed away at home in November of the previous year. Ms. Uludag had reported feeling unwell, experiencing dizziness and shortness of breath, the day before her death, but was hesitant to attend A&E due to concerns about long waiting times. On November 11, she became dizzy at home, fell, and hit her head. Despite paramedics attending after her daughter called for an ambulance, she went into cardiac arrest and died.

An inquest revealed that toxicology tests showed 1.94 milligrams of sertraline per litre of blood in Ms. Uludag's system. Experts noted that concentrations above 1.5 milligrams per litre are known to be a contributing factor in death. The coroner concluded that Ms. Uludag died as a result of an overdose, but emphasized there was no evidence it was intentional, describing it as an "unexpected and unintended consequence." Her medical cause of death was recorded as accidental sertraline overdose.

Sertraline, also marketed as Lustral in the UK and Zoloft in the US, is one of Britain's most commonly prescribed antidepressants. More than 24.4 million prescriptions for the drug were dispensed in England in 2024 alone. It belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which work by increasing serotonin levels in the brain. These medications are commonly prescribed for depression, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, and social anxiety disorder. The usual starting dose is 50mg once daily, with a maximum recommended dose of 200mg per day.

Symptoms of SSRI poisoning can include nausea, vomiting, agitation, tremor, drowsiness, and an increased heart rate, with convulsions possible in severe cases. Rarely, excessive serotonin levels can lead to serotonin syndrome, a potentially life-threatening condition. The NHS has warned that this syndrome can occur when SSRIs are taken with other medications that also increase serotonin levels, such as certain migraine drugs (triptans), pain medications (tramadol, methadone), herbal supplements (St John’s wort, ginseng), and cough medicines containing dextromethorphan. Symptoms of serotonin syndrome include confusion, agitation, muscle twitching, sweating, shivering, and diarrhoea, with rare cases involving hallucinations and inability to urinate. Immediate medical advice is crucial if these symptoms arise.

Beyond acute overdose, SSRIs are known for other side effects. The NHS cautions that some individuals may experience suicidal thoughts or a desire for self-harm when first taking SSRIs. A significant concern has been their impact on libido, with some users reporting long-term sexual dysfunction. This issue gained prominence in 2023 when Scottish singer Lewis Capaldi discussed the libido-dampening effects of the medication on his sexual health in a documentary. The powerful libido-reducing effects have even led to trials of these drugs on sex offenders to curb urges.

Doctors stress that antidepressants like sertraline are widely used and generally safe when taken as prescribed. The NHS advises against suddenly stopping antidepressants, even if feeling better, due to potential withdrawal symptoms. A major study in The Lancet also found that some antidepressants, including sertraline, can cause changes in weight, heart rate, and cholesterol levels during the initial eight weeks of treatment, suggesting treatment guidelines should reflect these differing risks between drugs.

Ms. Uludag's family stated there was never any suggestion she intended to harm herself, highlighting her love for her family and grandchildren. Her daughter expressed confusion and concern regarding the dosage, questioning why such an overdose occurred if her mother's intention was simply to feel better.