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) is used to treat depression, anxiety, and some forms of long-term pain. This medication is an antidepressant that's called an SNRI or serotonin and norepinephrine reuptake inhibitor. The dosage is typically one capsule by mouth once daily (or twice daily for some people with depression). Side effects can include nausea, headache, and dry mouth. If you need to stop the medication for any reason, your prescriber will lower your dose slowly over time to prevent withdrawal symptoms like anxiety and trouble sleeping.