Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Amitriptyline and alprazolam (Xanax) are both medications that can be used to treat anxiety, but they belong to different medication classes. Amitriptyline is a tricyclic antidepressant (TCA) primarily approved for depression, while alprazolam is a benzodiazepine approved for generalized anxiety disorder (GAD) and panic disorder. Amitriptyline is often used off-label for nerve pain and migraine prevention, whereas alprazolam is typically used for short-term anxiety relief. It is not reommended for long-term use due to its potential for misuse and dependence. Both medications are available as a lower-cost generic. Amitriptyline is usually taken once daily, often at bedtime, while alprazolam is taken multiple times a day. Common side effects of amitriptyline include sleepiness and weight gain, whereas alprazolam can cause drowsiness and memory problems. Both medications have significant drug interactions, so be sure your prescriber and pharmacist have a complete list of the medications you take.
Amitriptyline
Alprazolam (Xanax)
Amitriptyline
Alprazolam (Xanax)
Summary of Amitriptyline vs. Xanax
Summary for Tricyclic antidepressant
Prescription only
Amitriptyline is FDA approved to treat depression. But it isn't as commonly used today as other antidepressants because it can cause a lot of side effects, such as sleepiness and weight gain. In addition, amitriptyline has many interactions with other medications, including other antidepressants, sedatives, and antihistamines. But despite the side effects and interactions, amitriptyline is often used off label for nerve pain due to diabetes and migraine prevention. While its brand name Elavil is no longer available, amitriptyline is available as a generic medication.