MajorBenzodiazepines. Short-to-medium-acting anxiolytics×Tricyclic antidepressants (TCA)
Updated · Methodology
Mechanism
Additive CNS depression, sedation, and anticholinergic effect. In older patients: high delirium and fall risk.
Symptoms
Deep sedation, drowsiness, ataxia, confusion (especially in older patients). Dry mouth, constipation, urinary retention (anticholinergic effect).
Management
Avoid the combination in older patients. If needed, use the minimum effective dose of both with a short course. Alternative anxiolytic when a TCA is needed: hydroxyzine or gabapentinoids.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Xanax (alprazolam) prescribing information (2016)– ; DailyMed setid 388e249d-b9b6-44c3-9f8f-880eced0239f
- AEMPS: Ficha técnica: Amitriptilina (nº registro 89862), sección 4.5 (2026)– AEMPS, CIMA, nº registro 89862, revisión 05/2026, sección 4.5