Based on WHO | Do I need to avoid aged or fermented cheeses while taking sertraline?

You generally do not need to avoid aged or fermented cheeses while taking sertraline. Sertraline is a selective serotonin reuptake inhibitor (SSRI), not a monoamine oxidase inhibitor (MAOI), and the tyramine–cheese restriction applies to MAOIs. Tyramine‑rich foods like aged cheeses are restricted with MAOIs because they can trigger dangerous spikes in blood pressure, but this restriction does not apply to SSRIs such as sertraline. ^{[1] [2]}

Why the confusion happens

• MAOIs and tyramine: MAOIs block the enzyme that breaks down tyramine, so eating high‑tyramine foods (for example, aged cheeses, cured meats, some beers) during MAOI therapy can cause severe hypertension, the classic “cheese reaction.” ^{[1] [2]}
• SSRIs like sertraline: SSRIs do not inhibit monoamine oxidase and therefore do not raise tyramine levels from food in the same way. As a result, standard MAOI food restrictions are not required with sertraline. ^{[3] [4]}

What you can eat with sertraline

• Cheese and fermented foods: From a tyramine standpoint, aged or fermented cheeses, kimchi, sauerkraut, soy sauce, and similar foods are not routinely restricted with sertraline. These foods become a concern specifically with MAOIs, not SSRIs. ^{[1] [2]}
• Alcohol and caffeine: While not specifically contraindicated with sertraline, moderation is usually advised for alcohol and caffeine because they may worsen anxiety, sleep issues, or interact with other health conditions. ^[2]

When cheese restrictions do apply

If you are taking, switching to, or recently stopped an MAOI (for example, phenelzine, tranylcypromine, isocarboxazid, or the selegiline patch), you should avoid high‑tyramine foods during treatment and for a short period after stopping, according to medical guidance. This includes aged cheeses, cured meats, draft or unpasteurized beers, and other fermented or over‑ripe foods. ^{[1] [5]}

Examples of high‑tyramine foods in MAOI diets

• Aged cheeses such as aged cheddar, Parmesan, Swiss, blue cheeses (Stilton, Gorgonzola), and brie or Camembert. ^[5]
• Cured/fermented meats like salami, pepperoni, certain sausages. ^[2]
• Tap or unpasteurized beers and some artisan alcoholic beverages. ^[5]

These specific restrictions are to prevent tyramine‑induced hypertensive reactions with MAOIs, not with sertraline. If you were on an MAOI recently, clinicians typically recommend continuing food restrictions for several weeks after stopping the MAOI. ^{[1] [6]}

Important safety note about drug combinations

• Do not combine sertraline with an MAOI or use them too close together due to the risk of serotonin syndrome, a potentially serious reaction; clinicians require a washout period when switching between these drug classes. ^{[3] [7]}

Quick comparison table

Topic	Sertraline (SSRI)	MAOIs (e.g., phenelzine, tranylcypromine, selegiline patch)
Tyramine food restriction (e.g., aged cheeses)	Not routinely required	Required during therapy and for a short period after stopping
Reason	Does not inhibit monoamine oxidase	Inhibits monoamine oxidase → tyramine buildup → hypertensive crisis risk
Key dietary cautions	General moderation with alcohol/caffeine based on individual tolerance	Avoid high‑tyramine foods (aged cheeses, cured meats, certain beers, fermented foods)

SSRIs like sertraline do not carry the tyramine‑cheese restriction that applies to MAOIs. Unless you are on an MAOI now, recently used one, or are switching between an MAOI and sertraline, you do not need to avoid aged or fermented cheeses solely because of sertraline. ^{[1] [2]}