Drug interactions
Amitriptyline + Lithium
Severity: Moderate
Amitriptyline and Lithium: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both agents enhance serotonergic activity, and cases of serotonin toxicity and neurotoxicity have been described with lithium and tricyclics. Both can also affect cardiac conduction and QT interval, particularly with lithium toxicity or electrolyte disturbance.
What this interaction means in plain words
Amitriptyline and Lithium can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Lithium belongs to Central Nervous System.
Why it happens
Additive serotonergic enhancement and additive effects on cardiac repolarization.
What to do
Monitor for tremor, agitation, hyperreflexia, confusion and ECG changes, and check serum lithium levels regularly. Reduce doses or stop if serotonin toxicity or neurotoxicity appears.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Amitriptyline with Lithium?
MediHelp rates the interaction as moderate. Amitriptyline and Lithium can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both agents enhance serotonergic activity, and cases of serotonin toxicity and neurotoxicity have been described with lithium and tricyclics. Both can also affect cardiac conduction and QT interval, particularly with lithium toxicity or electrolyte disturbance.
How serious is the interaction between Amitriptyline and Lithium?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for tremor, agitation, hyperreflexia, confusion and ECG changes, and check serum lithium levels regularly. Reduce doses or stop if serotonin toxicity or neurotoxicity appears.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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