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Silenor vs. Vivactil

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

Key takeaways

Doxepin (Silenor) and protriptyline are both tricyclic antidepressants (TCAs) used to treat different conditions. Doxepin is primarily used for insomnia, specifically to help you stay asleep, while protriptyline is used to treat depression. Doxepin is taken once daily as a tablet before bedtime, whereas protriptyline needs to be taken 3 to 4 times a day. Doxepin is available in both brand-name and generic forms, while protriptyline is only available as a generic since the brand Vivactil is no longer available. Common side effects of doxepin include sleepiness and tiredness, while protriptyline can cause headache, blurry vision, and an upset stomach. 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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Protriptyline

 

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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 Vivactil

Prescription only

Protriptyline is used to treat depression. It's not as commonly used today as other newer antidepressants because it needs to be taken 3 to 4 times per day. In addition, it can cause many side effects including headache, blurry vision, restlessness, and stomach-upset.

Indications for Vivactil

  • Depression

Pros and Cons for Vivactil

Pros

  • Can take with or without food
  • Taken by mouth
  • Available as a lower-cost generic

Cons

  • Needs to be taken multiple times a day
  • Should be used with caution in older adults, especially if there's a history of heart problems
  • Can cause withdrawal symptoms if you suddenly stop taking it

Common Side Effects for Vivactil

  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Headache
  • Dry mouth
  • Blurry vision
  • Restlessness and anxiety
  • Tremors, shakiness
  • Trouble sleeping
  • Constipation
  • Change in taste
  • Trouble getting or maintaining an erection

Warnings for Vivactil

  • Worsening depression, suicidal thoughts, and unusual behavior
  • Not for use alone in bipolar disorder
  • Higher risk of falls
  • Risk of heart problems, heart attack, or stroke
  • Seizures
  • Glaucoma

Prices with our coupons for Silenor vs. Vivactil

Price Card Drug Icon
Doxepin30 tablets / 3mg
$53.04$315.55
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Price Card Drug Icon
Protriptyline90 tablets / 10mg
$131.16$488.77
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