Key takeaways
Amitriptyline (generic, formerly branded as Elavil) and desipramine (Norpramin) are both tricyclic antidepressants (TCAs) used to treat depression. Amitriptyline is often used off-label for nerve pain and migraine prevention, while desipramine is not. Amitriptyline can cause sleepiness and weight gain, and it has many interactions with other medications. Desipramine also causes sleepiness and weight gain but is more likely to cause confusion and anxiety. Amitriptyline is typically taken in divided doses or once at bedtime, whereas desipramine is usually taken once daily. Both medications can cause serious side effects like suicidal thoughts and heart problems, but desipramine has an additional risk of serotonin syndrome. Both are available in generic forms and are not controlled substances.
