tricyclic
2 interactions related to tricyclic
amitriptyline + st. john's wort
St. John's wort induces the cytochrome P450 enzymes (and the P-glycoprotein transporter) that clear amitriptyline, measurably lowering amitriptyline blood levels and reducing its antidepressant and pain-relieving effect. Because both also raise serotonin signaling, combining them adds a theoretical risk of serotonin syndrome. The net effect can be a weaker antidepressant plus an added safety concern.
alcohol + amitriptyline
Amitriptyline is a sedating tricyclic antidepressant with strong antihistaminic and anticholinergic effects. Combining it with alcohol — also a central nervous system depressant — produces additive drowsiness, impaired coordination and reaction time, and a greater risk of falls and accidents. The FDA label warns explicitly that amitriptyline may enhance the response to alcohol.