7 doctors weighed in:

Can i take amitriptyline with sertraline?

7 doctors weighed in
Dr. Joan Gelin
Emergency Medicine
4 doctors agree

In brief: Caution

These medicines are both from the same drug family.
Please talk with the doctor who is prescribing this medicine to you. As long as the medications are closely followed by the doctor, then the risk of having a bad drug-drug interaction will be very low. Take care ...

In brief: Caution

These medicines are both from the same drug family.
Please talk with the doctor who is prescribing this medicine to you. As long as the medications are closely followed by the doctor, then the risk of having a bad drug-drug interaction will be very low. Take care ...
Dr. Joan Gelin
Dr. Joan Gelin
Thank
2 comments
Dr. Louis Cady
I'm not sure I agree. Dr. Gelin is correct in that they are both antidepressants. 1) they are, however not from the same drug family - one is a tricyclic antidepressant (amitriptyline). The other (sertraline) is an SSRI. 2) Amitriptyline as, indeed, all of the TCA's, are metabolized through an enzyme system in the liver called the cytochrome P450 2 D 6 system. 3) There are different levels of metabolizers with respect to this system. Some people are extensive metabolizers, which means they clear the amitriptyline out like nobody's business. Some are intermediate metabolizers. And some are SLOW METABOLIZERS. if you are a SLOW METABOLIZER, and if your dose of Amitryptiline is significant (100 - 200 mg), there is a significant risk of a drug drug interaction. Bottom line: as long as the amitriptyline is being dosed at a LOW level, and the doc is going up slowly, it's probably safe. I'd still check some levels along the way, however. (This guarantees that the levels will not get too high.) Finally - do not me lulled into a false sense of security with the fact that Sertraline and amitriptyline can be taken together. Fluxoetine (Prozac) and paroxetine (Paxil), basically plug this metabolic pathway and they can shoot the leve of your amitriptyline through the roof. This has potentially fatal consequences with death from cardiac arrhythmia. I hope this is helpful.
Dr. Heidi Fowler
Wow, I agree with both responses. Dr. Cady - you knocked my socks off! Awesome info. Small doses of amitriptyline are often used at bedtime for sleep or pain in people who are taking SSRI's. Doctors often use psychiatric drugs for "off-label" use.
Dr. Robert Killian
General Practice

In brief: Mental Health

Yes.
Of course. I do not believe there to be any trouble with these two commonly prescribed medications.

In brief: Mental Health

Yes.
Of course. I do not believe there to be any trouble with these two commonly prescribed medications.
Dr. Robert Killian
Dr. Robert Killian
Thank
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