Is Sertraline an MAOI? (+3 differences)

This article will discuss whether Sertraline contains Monoamine oxidase inhibitor (MAOI). We will also discuss the key differences to help you understand the basic pharmacological use of these medications.

Is Sertraline a MAOI?

No, Sertraline is not a Monoamine oxidase inhibitor (MAOI). Sertraline is a selective serotonin reuptake inhibitor (SSRI), while MAOIs are a different class of antidepressants.

MAOIs are considered more effective than Sertraline for treating both depression and anxiety. However, they have more side effects and potential drug interactions.

Whereas, Sertraline works by increasing the levels of serotonin in the brain. It’s a relatively safe and well-tolerated medication but can cause side effects such as nausea, headaches, and sexual dysfunction.

How is Sertraline different from MAOIs?

Key differences between Sertraline and MAOIs are as follows:

Mechanism of action

Sertraline is a selective serotonin reuptake inhibitor (SSRI), which works by blocking the reuptake of serotonin, an excitatory neurotransmitter, in the brain. By doing so, the levels of serotonin increase in the brain for a longer period, which helps relieve symptoms associated with anxiety and depression (1).

Monoamine oxidase inhibitors (MAOIs) are a class of antidepressants used to manage and treat mental illnesses. It works by inhibiting the enzyme MAO, leading to its accumulation in the central nervous system.

MAOIs inhibit the breakdown of various neurotransmitters such as dopamine, serotonin, and norepinephrine. This biochemical effect increases the levels of serotonin and norepinephrine rapidly in the brain. This helps to regulate mood behaviour, anxiety, and depression.

Different types of MAOIs approved for clinical use are Isocarboxazid, Selegiline, Phenelzine, and Tranylcypromine (2).

Therapeutic uses

Sertraline and MAOIs have similar therapeutic uses, but they belong to different classes of antidepressants. Both medications can be used for the following conditions (3, 4):

• Depression
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder (SAD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Major depressive disorder

Here are some of the therapeutic uses that are different between Sertraline and MAOIs.

• Sertraline is used to treat Premenstrual dysphoric disorder (PMDD).
• It is generally considered a safer and well-tolerated drug than MAOIs, especially in individuals having underlying medical conditions.
• Sertraline is less likely to interact with food and other medications. It is used as the first line of treatment for depression.
• MAOIs are used to treat Parkinson’s disease, while Sertraline is not.
• Phenelzine (Nardil) an MAOI is used to treat bulimia nervosa and phobic symptoms.
• MAOIs are used to treat depression, clinically characterized as neurotic or atypical.

Side effects

Common side effects of Sertraline include (3):

• Dizziness
• Fatigue
• Night sweats
• Nause and vomiting
• Diarrhoea
• Insomnia
• Acid reflux
• Change in appetite/ weight
• Sexual dysfunction

Side effects associated with MAOIs are (5):

• Low blood pressure
• Weight gain
• Muscle cramps
• sexual dysfunction
• Paresthesia
• Involuntary muscle jerks.

Withdrawal symptoms

When discontinuing Sertraline, some individuals may experience withdrawal symptoms. These symptoms can vary in severity and may include, flu-like symptoms, dizziness, mood changes, sleep disturbances, nausea, and vomiting.

Discontinuation of MAOI can result in severe withdrawal symptoms in some people. These symptoms include worsening depression, hypotension, gastrointestinal problems, hypomania, headaches, tiredness, and agitation (5).

Sertraline and MAOI both are used to treat depression and other mental illnesses, but discontinuation of these medications can cause severe side effects. If you and your doctor decide to discontinue these medications, a tapering schedule is usually recommended to reduce the risk of withdrawal symptoms.

Can you take Sertraline and MAOIs together?

Sertraline and MAOI can not be taken together. The simultaneous use of these medications is generally contraindicated and should be avoided. The combination of these medications may lead to potential side effects such as serotonin syndrome.

Serotonin syndrome occurs when serotonin accumulates in the brain, and the symptoms can vary from mild to severe. These symptoms may include confusion, hypotension, rapid heart rate, dilated pupils, muscle stiffness, tremors, hyperthermia, seizures, and coma.

It can be dangerous to take these medications concomitantly; hence, it’s essential to closely communicate with your healthcare provider when changing the dose regimen, especially when transitioning between antidepressants such as SSRIs and MAOIs.

They can guide you on how to safely switch to another medication while minimizing the side effects.

How to choose between Sertraline and an MAOI?

The choice between Sertraline and an MAOI depends on the symptoms you’re experiencing, and the most suitable medication should only be decided by your healthcare provider.

Your healthcare provider recommends Sertraline or an MAOI depending on various factors, including your medical history, individual symptoms, and other medications you’re taking.

Sertraline is generally a first-line treatment for depression and anxiety because it’s safe and compliant. However, some individuals may not respond to sertraline, or they may experience side effects.

If you are struggling with depression and anxiety, it’s essential to communicate with your healthcare provider about the best treatment options for you.

Moreover, MAOIs are more effective than Sertraline for treating depression and anxiety but have potential side effects and interactions. MAOIs are only prescribed to individuals who have not responded to other antidepressants, such as SSRIs or SNRIs.

Your healthcare provider will consider your individual needs and potential risks when prescribing medications. Some additional considerations while choosing an antidepressant:

• Other underlying medical conditions
• Other medications you’re taking
• Your personal preferences
• The severity of your depression.

Conclusion

In conclusion, it’s understood that Sertraline is not an MAOI. The fundamental difference lies in their mechanisms of action, with Sertraline being an SSRI and MAOI acting on monoamine oxidase enzymes.

Further, we discussed the concomitant use of Sertraline and MAOIs and their possible side effects. It’s important to seek guidance from your healthcare provider before taking these medications.

References