Key takeaways
Amitriptyline (formerly branded as Elavil) and protriptyline (formerly branded as Vivactil) are both tricyclic antidepressants (TCAs) used to treat depression. Amitriptyline is also used off-label for nerve pain and migraine prevention, while protriptyline is not. Amitriptyline is typically taken once a day, often at bedtime, whereas protriptyline needs to be taken 3 to 4 times a day, which can be less convenient. Both medications can cause side effects like sleepiness, dizziness, and dry mouth, but amitriptyline is more likely to cause weight gain. Protriptyline, on the other hand, can cause restlessness and blurry vision. Both medications have risks of worsening depression and suicidal thoughts, especially in younger individuals. Amitriptyline is available in many strengths and is generally lower-cost as a generic, while protriptyline is also available as a lower-cost generic.
