Alcohol
It may be possible to drink some alcohol in moderation while taking amitriptyline. However, the two together might make you feel very sleepy and unsteady on your feet, especially when you first start taking the medication. It will also make you less alert when doing things that need focus, like driving.
During the first few weeks of treatment, it is recommended that you don’t drink alcohol until you know how the medicine affects you.
Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.
Street drugs
Amitriptyline does not mix well with recreational drugs.
If you mix cannabis and amitriptyline, you could get a fast heartbeat.
Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis.
If you take heroin or methadone with amitriptyline, you may feel extremely sleepy.
You could get an irregular and dangerous heartbeat if you take amitriptyline with cocaine, amfetamines, ecstasy, MDA or 6-APB.
There are many other street drugs, but we don’t know what effect taking them with amitriptyline will have, so it’s best to be cautious. There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.
Smoking
Cigarette smoke may affect the amount of amitriptyline in your body, although it is unlikely the dose of amitriptyline will need to be changed if you stop smoking or switch to using nicotine patches or vaping.
If you start or stop smoking while you are taking amitriptyline and you notice a deterioration in your mood or an increase in the side effects, contact your doctor to discuss this.
Get more advice on drugs and alcohol.