Elavil vs. Maprotiline for Depression: Important Differences and Potential Risks.

Key takeaways

Amitriptyline (generic name) and maprotiline (Ludiomil) are both antidepressants, but they belong to different classes. Amitriptyline is a tricyclic antidepressant (TCA), while maprotiline is a tetracyclic antidepressant. Amitriptyline is still available as a generic medication, whereas maprotiline has been discontinued in the United States since June 2021. Amitriptyline is used to treat depression and is also often used off-label for nerve pain and migraine prevention. In contrast, maprotiline was used to treat depression and anxiety associated with depression. Amitriptyline works by increasing levels of serotonin and norepinephrine in the brain, while maprotiline is thought to raise norepinephrine levels, although its exact mechanism is not fully understood. Amitriptyline has many side effects, including sleepiness and weight gain, and it interacts with many other medications. Maprotiline was likely discontinued due to the availability of newer antidepressants with fewer side effects.

Amitriptyline

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Maprotiline

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Summary for Elavil

Prescription only

Amitriptyline is also known by the old brand name Elavil. It's a tricyclic antidepressant (TCA) that's approved to treat depression. But it's not used as often today for depression because it can cause a lot of side effects, like sleepiness and weight gain. It also has many drug interactions. Even so, amitriptyline is often used off label for other reasons, like nerve pain from diabetes and to help prevent migraines. Amitriptyline comes as a generic tablet that you take by mouth. The brand name Elavil is no longer available.

Indications for Elavil

Depression

Pros and Cons for Elavil

Pros

Can start to work within 2 to 4 weeks
Can take with or without food

Cons

Has many unpleasant side effects, like dry mouth and sleepiness, and drug interactions
Not the best choice for people with heart problems, trouble urinating, or glaucoma or older adults

Common Side Effects for Elavil

Sleepiness
Dizziness
Weakness
Fatigue
Headache
Dry mouth
Nausea
Vomiting
Constipation
Weight gain

Warnings for Elavil

Worsening depression or suicidal thoughts and behavior
Serotonin syndrome
Not for use alone for bipolar disorder
Risk of heart problems, heart attack, or stroke
Low sodium levels
Risk of seizure
Angle-closure glaucoma in certain people

Summary for Maprotiline

Prescription only

Maprotiline is an antidepressant used to treat depression and anxiety associated with depression. It's no longer available in the United States because it was discontinued.