Can Trazodone Interact With Amitriptyline?(+9 Side Effect)

By Ivan Kahwa

Page last updated: 30/01/2024 | Next review date: 30/01/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

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In this article, we will discuss the interaction between trazodone and amitriptyline. We will also explore the potential adverse effects that may arise from the concurrent use of trazodone and amitriptyline, along with strategies for managing these adverse effects.

Can trazodone interact with amitriptyline?

Yes, trazodone can interact with amitriptyline. When these medications are combined, there is the potential for additive effects, which means the overall impact may be a combination of both drugs’ effects.

This interaction can have both beneficial and harmful aspects for patients. However, it’s crucial to recognize that the interactions between these medications can be complex, leading to effects that are challenging to predict.

Healthcare professionals may consider using this combination for the management of treatment-resistant mental disorders that do not respond to conventional therapy. However, this combination should only be used under the supervision of a qualified healthcare professional to avoid unwanted side effects.

What are the key differences between trazodone and amitriptyline?

Although both amitriptyline and trazodone are antidepressant medications, they may have some key differences, which may include (1,4):

Features	Trazodone	Amitriptyline
Class	Serotonin modulator	Tricyclic antidepressant
Indications	depression, anxiety, fibromyalgia, pain	depression, anxiety, migraine, neuropathic pain
Sedation	moderate	high
Side effects	mild	high
Risk	low	high

What does research suggest?

According to research, the combination of trazodone and amitriptyline may increase the risk of similar side effects associated with these medications.

In a research study, low doses of trazodone and amitriptyline were combined in the management of depression in individuals. This combination was effective in managing the symptoms of depression. However, some individuals reported severe agitation, aggression, restlessness, irritability, and symptoms of anxiety. Some patients also experienced serious symptoms of serotonin syndrome due to the combined effects of these medications on serotonin levels (2).

Another research study reported the occurrence of meiosis in individuals after taking a combination of amitriptyline and trazodone (3).

What are the potential effects of trazodone and amitriptyline interactions?

The potential interactions between trazodone and amitriptyline should be considered cautiously, as both substances can affect the central nervous system, potentially leading to additive effects.

Both trazodone and amitriptyline can increase serotonin levels. When used together, there’s a potential risk of serotonin syndrome, which can be manifested by the following symptoms:

agitation
hallucinations
palpitations
temperature changes
muscle stiffness
impaired coordination

Adverse effects

This combination may also result in additive side effects that may occur when taking these medications alone. However, the risk is increased when combined, potentially leading to serious complications. These side effects may include:

excessive sedation
impaired cognitive and motor functions
dizziness
drowsiness
nausea
vomiting
headaches
fatigue
cardiovascular effects

How to manage the additive side effects of trazodone and amitriptyline?

Managing the potential adverse effects of combining amitriptyline and trazodone can be challenging due to the complex and unpredictable interactions between the two medications.

Consult with your healthcare provider to discuss potential dosage adjustments for either medication, aiming to minimize the risk of adverse interactions and side effects.

Be cautious, as even lower dosages may lead to additive side effects, especially in susceptible patients.

Symptomatic treatment may be necessary to address any side effects that arise from combining amitriptyline and trazodone.

Consider exploring alternative therapies and treatments for managing symptoms or conditions for which you are taking trazodone. Your healthcare provider can suggest options with potentially fewer interactions.

In my opinion, the use of a combination of antidepressant medications should be limited to cases where the benefits of the therapy outweigh its risks and when dealing with resistant mental disorders.

Given that these medications have almost similar mechanisms and side effects, combining them may increase the risk of side effects and lead to additive effects that could worsen symptoms. Always consult your healthcare provider before taking any medication with trazodone to avoid unwanted and serious side effects

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References

1.-

Shin JJ, Saadabadi A. Trazodone. [Updated 2022 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/

2.-

Nisijima K, Shimizu M, Abe T, Ishiguro T. A case of serotonin syndrome induced by concomitant treatment with low-dose trazodone and amitriptyline and lithium. Int Clin Psychopharmacol. 1996 Dec;11(4):289-90. doi: 10.1097/00004850-199612000-00013. PMID: 9031998. https://pubmed.ncbi.nlm.nih.gov/9031998/

3.-

Longmore J, Banjar W, Bradshaw CM, Szabadi E. Effects of a controlled-release formulation of trazodone on psychomotor and autonomic functions in healthy volunteers: comparison with trazodone (conventional formulation), amitriptyline and placebo. Eur J Clin Pharmacol. 1988;34(1):97-9. doi: 10.1007/BF01061427. PMID: 3360055. https://pubmed.ncbi.nlm.nih.gov/3360055/

4.-

Thour A, Marwaha R. Amitriptyline. 2023 Jul 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30725910. https://pubmed.ncbi.nlm.nih.gov/30725910/

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Can trazodone interact with amitriptyline?(+9 side effect)