Key takeaways
Amitriptyline (Elavil) and trazodone (Desyrel) are both medications that can be used to treat depression, but they have important differences. Amitriptyline is a tricyclic antidepressant (TCA), while trazodone is a serotonin antagonist and reuptake inhibitor (SARI). Both medications are available as a lower-cost generic and no longer come in a branded version. Amitriptyline is also used off-label for nerve pain and migraine prevention, whereas trazodone is also used off-label for insomnia. Amitriptyline is typically taken in doses ranging from 50 mg to 100 mg per day, while trazodone's starting dose for depression is 150 mg per day. Common side effects of amitriptyline include sleepiness, weight gain, and dizziness, while trazodone can cause sleepiness, dry mouth, and dizziness. Both medications can interact with other drugs, especially those affecting serotonin levels, and should not be taken with MAOIs.
