Class landing · Tricyclics

Supplements and tricyclic antidepressants.

Serotonergic and anticholinergic supplements to watch alongside amitriptyline and nortriptyline.

Tricyclic antidepressants (amitriptyline, nortriptyline and others) are older antidepressants still widely used, often at low doses for nerve pain, migraine prevention and sleep. They raise serotonin and noradrenaline, and they carry anticholinergic effects such as dry mouth, constipation and drowsiness.

The serotonergic supplements (5-HTP, tryptophan, SAM-e, saffron and rhodiola) sit in the cautious tier: each can add to the serotonin effect and is worth reviewing before starting. St John’s Wort speeds up the CYP enzymes that clear these drugs and can lower their level, so it works against the medicine. Huperzine A pulls in the opposite direction to the drug’s anticholinergic action, another reason to check before combining.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

Your supplements

Add every supplement you take. Type a name and click each match to add it, as many as you like.

Your medications

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Anything we should know? (optional)

Pick any that apply. We adjust the findings where context changes the answer.

I confirm I am 18 or over. This tool gives evidence-graded information, not medical advice; always discuss changes with your GP or pharmacist.

Add all the supplements and medications you take, then check them together in one go.

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology

Your whole stack

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the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
where your current routine may be leaving you short of your goals
the evidence-backed compounds worth adding, and the ones worth dropping

It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.

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Something missing?

If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.