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Silenor vs. Surmontil

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

Key takeaways

Doxepin (Silenor) and trimipramine are both tricyclic antidepressants, but they are used for different reasons. Doxepin is FDA-approved for treating insomnia, specifically to help you stay asleep, while trimipramine is used to treat depression. The usual doxepin dosage is one 6 mg tablet once daily, 30 minutes before bedtime. In contrast, trimipramine is taken in divided doses throughout the day or as a single dose at bedtime, with a typical dosing range of 50 mg to 150 mg and a maximum of 200 mg daily. Doxepin is available in both brand-name and generic forms, whereas trimipramine is only available as a generic since the brand Surmontil is no longer available. Common side effects of doxepin include sleepiness and tiredness, while trimipramine can cause drowsiness, changes in blood pressure, and dizziness. Both medications can increase the risk of developing or worsening glaucoma. They may also increase the risk of heart problems.

Doxepin

(Silenor)

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Trimipramine

 

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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

Summary for Surmontil

Prescription only

Trimipramine is taken by mouth and used to treat depression. It's not a first-choice medication because it can cause many side effects, such as dizziness, dry mouth, anxiety, or heart problems.

Indications for Surmontil

  • Depression

Pros and Cons for Surmontil

Pros

  • Available as a lower-cost generic
  • Available in 3 different strengths, convenient if you need to adjust your dose
  • Can be taken once a day, usually before you go to bed

Cons

  • Might not notice changes in your mood until you've taken trimipramine for several weeks
  • Stopping trimipramine suddenly can cause withdrawal symptoms, such as nausea, headache, and discomfort
  • Can cause more side effects than other medications used to treat depression
  • Not recommended for use for people with certain medical conditions, such as heart problems, thyroid problems, or seizures

Common Side Effects for Surmontil

  • Drowsiness
  • Blood pressure changes
  • Feeling of pins and needles in your arms and legs
  • Dry mouth
  • Blurred vision
  • Nausea and vomiting

Warnings for Surmontil

  • Suicidal thoughts or behavior
  • Possible bipolar disorder
  • Serotonin syndrome
  • Heart problems
  • Drowsiness or sleepiness
  • Withdrawal symptoms

Prices with our coupons for Silenor vs. Surmontil

Price Card Drug Icon
Doxepin30 tablets / 3mg
$53.04$315.59
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Trimipramine30 capsules / 25mg
$62.27$203.31
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