Can I take evavil and another antidepressant together?

[Hopeful Ic]

I am currently taking evavil 50 mg for ic. But I am having a lot of depression and anxiety. I am wondering if I take another antidepressant such as zoloft or lexapro will it mess my bladder up or make the elavil less affective?

[tigger_gal]

I wouldn't do anything like that with out talking to your doctor. you could have a heart attack, or massive allergic reaction by mixing the 2 meds..
Sorry you are having a hard tiem.. Call your doctor and see what he suggests..
hugs to ya

[Hopeful Ic]

No I do not plan to mix them myself I am going to a different doctor for anxiety and I am wondering if she puts me on zoloft or lexapro if it will mess up my treatment with elavil because regardless of anxiety I can not have my elavil not working right.

[creatingkarma]

I was prescribed elavil & lexapro together. I hope you feel better.

[ICNDonna]

Just be sure all of your doctors have a list of all of the medications, including herbs and natural remedies, you are taking.

Donna

[vm]

I also take Lexapro and Elavil together - the Lexapro was prescribed by a psychiatrist and he knew I am on Elavil.

[Briza]

I don't know about other antidepressants, but I do know that Prozac and Elavil should not be mixed. Definitely talk to your doctor. There are also drug interaction websites where you can look up information on this. This one is easy to use:
http://www.subscriberx.com/iqhealth/druginfostart.html

[vm]

I'm not seeing at that link that Elavil can't be taken with Prozac. The only caution it gives is against grapefruit juice. :confused:

[Briza]

This is the info I found on
http://www.subscriberx.com/iqhealth/druginfostart.html

MAJOR Drug-Drug
Prozac (fluoxetine) and Elavil (amitriptyline)
GENERALLY AVOID: Coadministration with fluoxetine may significantly increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is fluoxetine inhibition of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of many antidepressant and psychotropic drugs. Seizures and delirium have been reported, as well as a fatality attributed to fluoxetine-induced chronic amitriptyline toxicity. Pharmacodynamically, the combination of fluoxetine (or any other selective serotonin reuptake inhibitor) and a TCA may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors.
MANAGEMENT: In general, the use of fluoxetine (or other SSRIs) with TCAs should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Pharmacologic response and plasma TCA levels should be monitored more closely whenever fluoxetine is added to or withdrawn from therapy in patients stabilized on their existing antidepressant regimen, and the TCA dosage adjusted as necessary. Patients should be monitored closely for signs and symptoms of TCA toxicity (e.g., sedation, dry mouth, blurred vision, constipation, urinary retention) and/or excessive serotonergic activity (e.g., CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia). Due to the long half-life of fluoxetine and its active metabolite, norfluoxetine, the risk of interaction may persist for several weeks after discontinuation of fluoxetine.

MODERATE Drug-Food
Elavil (amitriptyline)
MONITOR: Grapefruit juice may increase the plasma concentrations of some orally administered drugs that are substrates of the CYP450 3A4 isoenzyme. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability. MANAGEMENT: Patients who regularly consume grapefruits and grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that are metabolized by CYP450 3A4. Grapefruits and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs.

[Hopeful Ic]

I can not figure out that website I am trying to find out about zoloft and evail if anyone can help let me know. I may just ask for lexapro since that is safe but I would like to know about zoloft too.

[Briza]

Hopeful IC
I'll look up the information on zoloft and lexapro and post it.

[Briza]

MAJOR Drug-Drug

Lexapro (escitalopram) and Elavil (amitriptyline)

MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and 5-hydroxytryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors. MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Close monitoring is recommended for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia. Particular caution is advised when increasing the dosages of these agents.

[Briza]

--------------------------------------------------------------------------------
MAJOR Drug-Drug

Zoloft (sertraline) and Elavil (amitriptyline)

MONITOR CLOSELY: Coadministration with sertraline may increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is sertraline inhibition of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of many antidepressant and psychotropic drugs. Moderate to significant increases (up to 250%) in plasma levels have been reported for desipramine and nortriptyline. Pharmacodynamically, the combination of sertraline (or any other selective serotonin reuptake inhibitor) and a TCA may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. The syndrome has been reported in a case involving sertraline and amitriptyline. MANAGEMENT: Caution is advised if sertraline (or other SSRIs) is prescribed with TCAs. Pharmacologic response and plasma TCA levels should be monitored more closely whenever sertraline is added to or withdrawn from therapy in patients stabilized on their existing antidepressant regimen, and the TCA dosage adjusted as necessary. Patients should be monitored closely for signs and symptoms of TCA toxicity (e.g., sedation, dry mouth, blurred vision, constipation, urinary retention) and/or excessive serotonergic activity (e.g., CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia).
MODERATE Drug-Food

Zoloft (sertraline)

MONITOR: Grapefruit juice may increase the plasma concentrations of some orally administered drugs that are substrates of the CYP450 3A4 isoenzyme. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability. MANAGEMENT: Patients who regularly consume grapefruits and grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that are metabolized by CYP450 3A4. Grapefruits and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs.

[Briza]

Don't feel bad, it took me a while to figure out how to use this particular drug interaction website, too! But it was easier than some of the others.

[charmedx3]

I Am On Zoloft 50mg &amitriptyline 50mg. I Was Worried About The Interaction Of The 2. Talked To My Uro About It She Said It Was Ok. I Was Still Nervouse So Talked To My Pharmacist And It Explained That Since The Ami Was Such A Low Dose There Was No Concern.

[Hopeful Ic]

Well the doctor put me on cymbalta with my elavil and I had a horrible night of either side effects or allergic reactions. I had chills fast heart beat grusome thoughts it freaked me out they told me to stop taking the cymbalta because that is what did it but I wonder if it was the mixture of the two or just an allergic reaction

[mayray518]

I was on elavil and prozac at the same time and the doc said it was fine but you should check all meds out with doc.

[vm]

Pharmacologic response and plasma TCA levels should be monitored more closely whenever fluoxetine is added to or withdrawn from therapy in patients stabilized on their existing antidepressant regimen, and the TCA dosage adjusted as necessary.

Huh, never knew that. I am sure it must be more of a risk with higher doses of Elavil. Most of us are on tiny doses compared with what is prescribed for depression. BUT, good to know for those who are on high doses for sure. Thanks for the info. :)