Can I take Amitriptyline and Trazodone together?

Why this happens

Both drugs increase the levels of a chemical called serotonin in the brain; too much serotonin can lead to toxicity. Additionally, both drugs have sedative effects and can interfere with the electrical signals in the heart (QT prolongation).

What you should do

You should only take these two medications together if specifically prescribed by a specialist who is monitoring you closely. Seek immediate medical help if you experience a very fast or irregular heartbeat, severe dizziness, fainting, muscle stiffness, tremors, or high fever. Avoid driving or operating machinery until you know how this combination affects you.

Important precautions

Depression and mental health disorders

Both medicines can increase thoughts of self-harm or suicide, particularly when first starting the medicine or changing the dose. Monitor your mood closely and seek urgent medical help if you experience any distressing thoughts.

Serotonin Syndrome risk

Do not take these medicines with other antidepressants or St John's Wort. Combining them can cause a life-threatening condition called serotonin syndrome, marked by high fever, agitation, and muscle rigidity.

Heart rhythm disorders (Long QT)

These medicines can affect your heart rhythm. You must inform your doctor if you have a history of heart disease or a slow heart rate, as they can trigger a dangerous irregular heartbeat.

Glaucoma (Acute Angle-Closure)

Amitriptyline can cause a sudden, painful increase in eye pressure. Do not take this medicine if you have a history of glaucoma without specialist advice, and seek immediate help if you experience sudden blurred vision or eye pain.

Food and drink warnings

Alcohol

You should avoid or strictly limit alcohol while taking these medicines. Both amitriptyline and trazodone cause drowsiness; alcohol significantly increases this effect, which can impair your coordination, judgment, and breathing. It can also make your depression or anxiety worse.

Caffeine (Coffee, Tea, Energy Drinks)

Amitriptyline can sometimes increase the effects of caffeine, making you feel jittery, anxious, or unable to sleep. Conversely, high amounts of caffeine may reduce the sedative effectiveness of the medicine. Try to keep your caffeine intake consistent and moderate.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.