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Compare Elavil vs. Topamax

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

Key takeaways

Amitriptyline (formerly branded as Elavil) and topiramate (Topamax, Qudexy XR, and Trokendi XR) are both prescription medications, but they serve different primary purposes and belong to different drug classes. Amitriptyline, available as a generic, is a tricyclic antidepressant (TCA) primarily used to treat depression, though it is also used off-label for nerve pain and migraine prevention. It works by increasing levels of serotonin and norepinephrine in the brain. On the other hand, topiramate, also available in generic form, is an antiepileptic medication used to treat seizures and prevent migraines. Its exact mechanism for preventing migraines is unclear, but it helps control seizures by reducing nerve activity in the brain. Amitriptyline can cause side effects like sleepiness and weight gain, while topiramate can lead to weight loss and cognitive issues like trouble thinking clearly. Additionally, topiramate has a risk of causing kidney stones and serious eye problems, which are not common concerns with amitriptyline. Both medications have significant interactions with other drugs, but topiramate also requires careful monitoring for blood acid levels and potential birth defects if taken during pregnancy.

Amitriptyline
Topiramate
Amitriptyline
Topiramate
Summary of Elavil vs. Topamax
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.
Summary for Antiepileptic
Prescription only
Topiramate is a prescription medication that can be used alone or in combination with other medications to treat certain types of seizures. It can also be used to prevent migraines. It comes in immediate-release and extended-release tablets and capsules, as well as a liquid. Topiramate is typically taken by mouth once or twice daily, depending on what formulation you're using. Some forms of topiramate are available as lower-cost generic medications.
Indications of Elavil vs. Topamax
Indications for

•Depression

Indications for

•Seizures (partial seizures, tonic-clonic seizures, Lennox-Gastaut syndrome)

•Migraine prevention
Pros and Cons of Elavil vs. Topamax
Pros and Const for Tricyclic antidepressant
Pros

•Available in many different strengths

•Available as a lower-cost, generic form

•Can take with or without food

Cons

•Has many unpleasant side effects compared to other antidepressants

•Can cause withdrawal symptoms if you suddenly stop taking it after long-term use

•Not the best choice for people with heart problems, glaucoma, or seizures or people age 65 years and older

Pros and Const for Antiepileptic
Pros

•Can be used on its own or with other medications to control seizures

•Available in short-acting and long-acting forms, so options to take once or twice daily

•Available as a solution (Eprontia), so it's convenient for people who have trouble swallowing

•Can be used to treat different types of seizures

•Can be used to treat seizures in both adults and children

Cons

•Can prevent migraines from happening, but it won't help if you have a migraine attack

•Can cause kidney stones

•Can cause serious eye problems

•Interacts with many medications, such as warfarin (Coumadin), phenytoin (Dilantin), and divalproex (Depakote)

•Children taking this medication for long periods of time will need to have their doses adjusted often due to changes in body weight as they grow
Common Side Effects of Elavil vs. Topamax
Common Side Effects for

•Sleepiness

•Dizziness

•Weakness

•Fatigue

•Headache

•Dry mouth

•Nausea

•Vomiting

•Constipation

•Weight gain

Common Side Effects for
Please note: These are common side effects reported by children and adults who took immediate-release topiramate. Frequency of side effects can differ based on your age, as well as the dose and formulation of topiramate you're taking.

•Feeling "pins and needles"

•Drowsiness

•Weight loss

•Nervousness

•Fatigue

•Dizziness

•Lack of appetite

•Trouble sleeping

•Upper respiratory tract infection (e.g., cough, stuffy nose, sore throat)

•Fever

•Change in taste

•Trouble moving or keeping balance
Warnings of Elavil vs. Topamax
Common Side Effects for

•Worsening depression, suicidal thoughts, and unusual behavior

•Not for use alone in bipolar disorder

•Risk of heart problems, heart attack, or stroke

•Seizures

•Glaucoma

•Higher risk of falls

Common Side Effects for

•Vision problems

•High body temperature and trouble sweating

•Higher level of acid in blood

•Suicidal thoughts or behavior

•Problems with mood and thinking clearly

•Higher ammonia level in blood

•Serious birth defects

•Skin reactions

•Withdrawal seizures

•Interaction with other medications
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Compare Elavil vs. Topamax

Key takeaways

Summary of Elavil vs. Topamax

Indications of Elavil vs. Topamax

Pros and Cons of Elavil vs. Topamax

Common Side Effects of Elavil vs. Topamax

Warnings of Elavil vs. Topamax

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