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Elavil vs. Silenor

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Amitriptyline (formerly branded as Elavil) and Silenor (doxepin) are both tricyclic antidepressants, but they are used for different purposes. Amitriptyline is primarily FDA approved to treat depression, though it is also used off-label for nerve pain and migraine prevention. In contrast, Silenor is specifically approved to treat insomnia, helping you stay asleep through the night. Amitriptyline can cause a range of side effects, including sleepiness, weight gain, and dizziness, and it has many interactions with other medications. Silenor, on the other hand, is noted for not being addictive and is generally taken once daily before bedtime. However, it can cause sleepiness and unusual behaviors while not fully awake. While both medications can worsen depression or cause suicidal thoughts, this risk is more pronounced in younger individuals. Additionally, Silenor should be taken on an empty stomach, unlike amitriptyline, which can be taken with or without food.

Amitriptyline

 

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Doxepin

(Silenor)

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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

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 Silenor

Prescription only

Doxepin (Silenor) is a tricyclic antidepressant that's used to help adults who have insomnia (trouble sleeping) stay asleep. Doxepin (Silenor) is a tablet that you take by mouth 30 minutes before bedtime. As expected, the most common side effects are sleepiness and tiredness, so only take the medication when you're ready to fall asleep for the night. Unlike some other sleep medications, doxepin (Silenor) isn't considered a controlled substance. Doxepin (Silenor) is available as brand-name and generic versions.

Indications for Silenor

  • Insomnia (specifically trouble staying asleep)

Pros and Cons for Silenor

Pros

  • Taken once a day close to bedtime
  • Few side effects (other than sleepiness)
  • Non-addictive sleep medication

Cons

  • Shouldn't take with food (must take at least 3 hours before or after food)
  • Risk of doing activities while you're not fully awake and not remembering that you did them the next day
  • Not approved for people younger than 18 years of age

Common Side Effects for Silenor

  • Sleepiness or tiredness (up to 9%)

Warnings for Silenor

  • Check for other causes of insomnia
  • Behavior changes
  • Worsened depression and risk for suicidal thoughts and behavior
  • Sleepiness and tiredness

Prices with our coupons for Elavil vs. Silenor

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Amitriptyline30 tablets / 25mg
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Doxepin30 tablets / 3mg
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