Does sertraline contain an MAOI? (3+ key differences)

In this article, we will discuss whether sertraline contains an MAOI (monoamine oxidase inhibitor). We will also talk about the basic differences between MAOIs and sertraline and discuss which antidepressant is safer to take. 

Does sertraline contain an MAOI? 

No, sertraline does not contain a monoamine oxidase inhibitor (MAOI). Sertraline is an antidepressant categorised as a selective serotonin reuptake inhibitor (SSRI). (1,2)

Monoamine oxidase inhibitors are also antidepressants, but they work differently. Drugs like Selegiline, Rasagiline, etc, belong to this category
(3). These medications are not used as a first line of therapy for depression and related symptoms. 

This is because SSRIs, including sertraline, are the first type of antidepressant prescribed for the treatment of depression and anxiety, and most people respond well to these medications. 

However, individuals vary, and some people might respond well to MAOIs. These two classes of antidepressants are completely different and have no link with one another. Make sure you closely follow your doctor’s direction and only take the antidepressant prescribed to you.

How is sertraline different from MAOIs?

Sertraline different from MAOIs in the following ways:

Mechanism of action 

Sertraline and MAOIs differ in their mechanisms of action. Sertraline, belonging to the class of SSRIs, works by increasing the levels of serotonin in the brain. This neurotransmitter plays a crucial role in regulating mood (1). 

MAOIs, on the other hand, inhibit the action of the enzyme monoamine oxidase, an enzyme which is responsible for the breakdown of excitatory neurotransmitters, leading to increased levels of serotonin, norepinephrine, and dopamine (3).

Therapeutic benefits

The therapeutic uses of sertraline and MAOIs also vary. Sertraline is commonly prescribed for conditions such as depression, anxiety disorders, and obsessive-compulsive disorder (1,2). 

MAOIs are often reserved for cases where other antidepressants have not been successful due to their potential for interactions and dietary restrictions (3).

Side effect profiles 

Both medications have distinct side effect profiles. Sertraline is generally well-tolerated, with common side effects including nausea, insomnia, and weight changes (1,2,4). 

MAOIs, on the other hand, can cause more severe side effects and have more interactions with drugs and foods (3). For example, taking tyramine-containing foods with MAOIs may lead to a hypertensive crisis.

Withdrawal symptoms

Withdrawal symptoms can occur when discontinuing either sertraline or MAOIs. Abruptly stopping sertraline may lead to symptoms such as dizziness, nausea, and irritability (1). 

MAOIs, due to their impact on neurotransmitter levels, can cause withdrawal symptoms such as mood changes, fatigue, and flu-like symptoms (3).

How to choose between sertraline and MAOIs?

The choice between sertraline and MAOIs depends on your symptoms and what your doctor considers best for you. Only a qualified mental healthcare professional can determine the best possible antidepressant for you, and you should never take such matters into your own hands. 

If your doctor believes that your symptoms will respond better to MAOIs, they will prescribe a suitable member of this family. However, MAOIs are considered a last resort, and SSRIs like sertraline are first-line drugs for depression and anxiety. 

If, for some reason, SSRIs don’t work, another class of antidepressants called serotonin-norepinephrine reuptake inhibitors (SNRIs) might be prescribed next. Examples include duloxetine, venlafaxine, desvenlafaxine, etc. SNRIs can manage other conditions as well, such as chronic pain, because of how these medications work. 

Furthermore, other antidepressants like bupropion, mirtazapine, trazodone, etc., are also commonly prescribed. The use of MAOIs is not as common as these antidepressants.

It is also important to note that some people may experience severe depression or major depressive disorder (MDD). In such cases, antidepressant monotherapy may not work well, and doctors may add another antidepressant to your regimen for enhanced therapeutic effects. 

The thing with MAOIs is that these antidepressants are not team players because of how they work. MAOIs, when paired with other antidepressants, can lead to a deadly condition called serotonin syndrome. 

This is why MAOIs are not used in combination with other antidepressants and are often prescribed alone. If your doctor believes that MAOIs are better for you, you should trust your doctor’s expertise, follow the directions, monitor your side effects, and discuss them with your doctor. 

This helps maintain the safety and efficacy of the chosen antidepressant, and your doctor can take necessary actions promptly.

Can you take sertraline and an MAOI together?

No, you should never take sertraline and MAOIs together. This combination, or the combination of an MAOI with any other antidepressant, can lead to a rare but life-threatening condition – serotonin syndrome. 

This syndrome can affect people differently and cause disturbing symptoms like (5):

  • Agitation or restlessness
  • Rapid heartbeat or high blood pressure
  • Dilated pupils
  • Loss of muscle coordination or twitching muscles
  • Heavy sweating
  • High fever
  • Diarrhoea
  • Confusion
  • Shivering or goosebumps

If you have accidentally taken the two together, it is important to seek immediate medical attention. 

As a pharmacist, I always talk about the safety of antidepressants and guide my patients to ensure they meet their therapeutic goals as safely as possible. 

If you are currently taking an antidepressant but you’re convinced that it is not doing much even after taking it consistently for weeks, please talk to your doctor. 

You should never increase your dose, take the antidepressant more often, or combine it with another medication without consulting your doctor first.


  1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from:
  1. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from:
  1. Sub Laban T, Saadabadi A. Monoamine Oxidase Inhibitors (MAOI). 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30969670. 
  1. National Library of Medicine. Sertraline: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from:
  1. Simon LV, Keenaghan M. Serotonin Syndrome. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29493999. Available from:

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