Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Amitriptyline (formerly branded as Elavil) and Prozac (fluoxetine) are both used to treat depression, but they belong to different classes of medications. Amitriptyline is a tricyclic antidepressant (TCA) that works by increasing levels of serotonin and norepinephrine in the brain, while Prozac is a selective serotonin reuptake inhibitor (SSRI) that primarily raises serotonin levels. Amitriptyline is often used off-label for nerve pain and migraine prevention, whereas Prozac is also approved for conditions like obsessive-compulsive disorder (OCD), bulimia, panic disorder, and depression from bipolar 1 disorder. Prozac is typically taken once daily, but it can also be taken weekly in a delayed-release form for depression, while amitriptyline is usually taken multiple times a day or once at bedtime. Common side effects of amitriptyline include sleepiness and weight gain, whereas Prozac may cause headaches, difficulty sleeping, and tiredness. Both medications can cause withdrawal symptoms if stopped abruptly and have a risk of worsening depression and suicidal thoughts, especially in younger individuals.
Amitriptyline
Fluoxetine (Prozac)
Amitriptyline
Fluoxetine (Prozac)
Summary of Elavil vs. Prozac
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.