ModerateTricyclic antidepressants (TCA)×Anxiolytics. Benzodiazepine derivatives
Updated · Methodology
Mechanism
Additive CNS depression and sedation. Older patients: delirium and fall risk.
Symptoms
Deep sedation, drowsiness, ataxia, confusion. Older patients: delirium and fall risk.
Management
Avoid the combination in older patients. If an anxiolytic is needed: minimum effective lorazepam or oxazepam dose (short-acting). For neuropathic pain, an alternative to amitriptyline: gabapentin or pregabalin.
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