tca
3 interactions related to tca
amitriptyline + st. john's wort
St. John's wort induces CYP3A4 and CYP2D6 enzymes that metabolize amitriptyline, reducing its plasma concentrations by up to 22%, while simultaneously adding serotonergic activity that can trigger serotonin syndrome. The combined result is paradoxical: less antidepressant effect plus higher risk of a potentially fatal serotonin reaction.
alcohol + amitriptyline
Amitriptyline is a tricyclic antidepressant with strong sedating, anticholinergic, and antihistaminic effects. Combining it with alcohol — also a CNS depressant — produces marked additive sedation, impaired psychomotor performance, and increased risk of falls, accidents, and respiratory depression in overdose.
nortriptyline + st. john's wort
St. John's wort induces CYP3A4 and CYP2D6, the enzymes responsible for metabolizing nortriptyline, reducing nortriptyline blood levels and antidepressant effect. The herb also adds serotonergic activity that may increase risk of serotonin syndrome.