Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Amitriptyline (generic, formerly branded as Elavil) and Cymbalta (duloxetine) are both used to treat depression, but they belong to different classes of medications. Amitriptyline is a tricyclic antidepressant (TCA) that works by increasing serotonin and norepinephrine levels in the brain, while Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI) that also raises these chemicals. Amitriptyline is often used off-label for nerve pain and migraine prevention, whereas Cymbalta is FDA-approved for additional conditions like anxiety, diabetic neuropathy, fibromyalgia, and chronic musculoskeletal pain. Amitriptyline can cause side effects like sleepiness and weight gain, and it has many drug interactions. Cymbalta's common side effects include nausea, headache, and dry mouth, and it can also cause liver damage and increase bleeding risk. Both medications can lead to withdrawal symptoms if stopped abruptly, but Cymbalta is generally considered to have a broader range of approved uses.
Amitriptyline
Duloxetine (Cymbalta)
Amitriptyline
Duloxetine (Cymbalta)
Summary of Elavil vs. Cymbalta
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.
Summary for SNRI
Prescription only
Duloxetine (Cymbalta) helps treat depression and anxiety. It can also help with some types of chronic pain, such as nerve pain from diabetes. Duloxetine (Cymbalta) is a type of antidepressant called an SNRI, or serotonin and norepinephrine reuptake inhibitor. Most people take it by mouth once a day, but some with depression might take it twice a day. Side effects include nausea, headache, and dry mouth. When it's time to stop taking the medication, the prescriber will slowly lower your dose to help prevent withdrawal symptoms.