Can I take Amitriptyline and Sertraline together?

You should only take amitriptyline and sertraline together if specifically instructed and monitored by your doctor.

Combining them increases the risk of serotonin syndrome and amitriptyline side effects.

Why this happens

Both drugs increase a chemical in the brain called serotonin; too much of this can be dangerous.

Additionally, sertraline slows down the liver's ability to break down amitriptyline, leading to higher levels of the drug in your bloodstream.

How to know if you're having a drug interaction

You may be experiencing an interaction between amitriptyline and sertraline if you experience:

• Confusion.

• Sweating.

• Shivering.

• A very fast heartbeat.

• Muscle stiffness.

Seek immediate medical help if you have any of these symptoms.

Important precautions

Serotonin Syndrome

Taking these medicines together significantly increases the risk of serotonin syndrome, a potentially life-threatening condition. Seek urgent medical help if you experience high fever, agitation, confusion, or muscle twitching.

Suicidal thoughts

These medicines can increase thoughts of self-harm or suicide, particularly in the first few weeks of treatment or when the dose is changed. Patients under 25 are at higher risk.

Heart rhythm disorders

Amitriptyline can affect your heart rhythm (QT prolongation). It must be used with extreme caution if you have an existing heart condition or are taking other medicines that affect the heart.

Bleeding disorders

Sertraline can increase your risk of bleeding, particularly from the stomach. Use with caution if you take blood-thinning medicines (like warfarin) or anti-inflammatory painkillers (like ibuprofen or aspirin), as this significantly increases the risk of serious bleeding.

Food and drink warnings

Alcohol

You should avoid or strictly limit alcohol while taking these medicines. Both amitriptyline and sertraline can cause drowsiness and dizziness; alcohol significantly increases these effects, which can impair your coordination and ability to drive or operate machinery safely.

Caffeine

Amitriptyline can sometimes cause a fast or irregular heartbeat. High amounts of caffeine can worsen this effect or increase feelings of anxiety and restlessness, potentially counteracting the benefits of the medicine.

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.