Your session is about to expire
Elavil vs Trazodone
Introduction
For patients with major depressive disorder (MDD) or other forms of depression, certain medications that modify the brain's neurotransmitter concentrations can help stabilize emotional lows and manage symptoms. Elavil and Trazodone are two such drugs often prescribed for these conditions. Both affect different neurotransmitters in the brain but have mood-stabilizing properties in patients with depression. Elavil is a tricyclic antidepressant (TCA), which increases serotonin and norepinephrine levels while blocking acetylcholine to alleviate depressive symptoms. On the other hand, Trazodone falls under the category of serotonin antagonist and reuptake inhibitors (SARIs), primarily enhancing serotonin activities by inhibiting its uptake in the nerve cells and partially blocking its action.
Elavil vs Trazodone Side By Side
| Attribute | Elavil | Trazodone |
|---|---|---|
| Brand Name | Elavil | Trazodone |
| Contraindications | Should not be used with or within 5 weeks of MAOIs. | Should not be used with or within 5 weeks of MAOIs. |
| Cost | For brand name: around $80 for 30 tablets of 25 mg. For generic (amitriptyline): $4 to $10 for 28 capsules of 25mg. | For brand name: about $15 for 30 tablets of 50 mg. For generic: $4-$20 for quantities starting at seven tablets up to hundreds. |
| Generic Name | Amitriptyline | Trazodone |
| Most Serious Side Effect | Thoughts of suicide or self-harm, severe allergic reactions, skin reactions, vision problems, cardiac symptoms, low sodium levels, severe nervous system reaction. | Signs of an allergic reaction, severe skin reactions, thoughts about suicide or hurting yourself, seizure, changes in mood or behavior, blurred vision, rapid heartbeat, irregular heart rhythm, low levels of sodium. |
| Severe Drug Interactions | Monoamine oxidase inhibitors (MAOIs). | Monoamine oxidase inhibitors (MAOIs). |
| Typical Dose | 75 mg/day up to a maximum of 150 mg/day for adults. Maximum dosage not to exceed 300 mg/day. | 50-100 mg/day at bedtime, can be increased to up to 150 mg/day. Maximum dose for severe cases may reach up to 400 mg/day for outpatients and 600 mg/day for inpatients. |
What is Elavil?
Amitriptyline (the generic name for Elavil) was one of the first drugs that came into use as a tricyclic antidepressant (TCA). It was approved by the FDA in 1961. Elavil increases levels of free serotonin and norepinephrine in the brain by preventing them from being reabsorbed, prolonging their activity and boosting mood. It is often prescribed for different forms of depression as well as certain types of nerve pain.
On the other hand, Trazodone is a newer drug compared to Amitriptyline. It belongs to a class known as serotonin antagonist and reuptake inhibitors (SARIs), which operate slightly differently than TCAs like Amitriptyline. While it also works primarily on serotonin like Elavil, it has less effect on norepinephrine, making its action more specific with potentially fewer side effects related to noradrenergic activities such as increased heart rate or blood pressure elevation.
What conditions is Elavil approved to treat?
Elavil is approved for the treatment of various conditions, including:
- Major depressive disorder
- Neuropathic pain
- Migraine prevention
On the other hand, Trazodone is primarily used for:
- Major depressive disorder with or without anxiety
- Insomnia (off-label use)
How does Elavil help with these illnesses?
Elavil, also known as amitriptyline, helps manage depression by increasing the amount of norepinephrine and serotonin available in the synapses of the brain. It achieves this by inhibiting their reuptake into nerve cells, thus keeping levels higher for a longer duration. Norepinephrine and serotonin are neurotransmitters that act as messengers within the brain and throughout the body, playing critical roles in mood regulation, anxiety control, sleep patterns and appetite. Depression is often associated with imbalances in these neurotransmitters. By elevating norepinephrine and serotonin levels, Elavil can help mitigate depressive symptoms and assist patients in managing their condition.
On the other hand, Trazodone also aids in managing depression but it primarily focuses on modulating serotonin levels rather than both norepinephrine and serotonin like Elavil does. It works similarly through inhibiting reuptake of serotonins resulting to increased availability at synapses which then helps improve mood stability among individuals suffering from depression.
What is Trazodone?
Trazodone is an antidepressant sold under multiple brand names, including Desyrel. It's classified as a serotonin antagonist and reuptake inhibitor (SARI), meaning it increases the amount of serotonin—a neurotransmitter linked to mood—in the brain by inhibiting its reabsorption. In addition, trazodone acts as an antagonist or blocker for certain receptors in the brain that respond to serotonin, which further helps enhance mood.
Unlike Elavil (amitriptyline), which is a tricyclic antidepressant known to cause weight gain and sexual dysfunction among other side effects, Trazodone does not have these common side effects associated with many older types of antidepressants. This makes it more tolerable for patients who may have experienced such adverse reactions from medications like Elavil.
Trazodone was first approved by the FDA in 1981 and has since been used effectively for treating major depressive disorder especially in patients who don't respond well to typical SSRI drugs or those unable to tolerate side effects from older types of antidepressants.
What conditions is Trazodone approved to treat?
Trazodone is a medication that has been approved by the FDA for treating:
- Major Depressive Disorder (MDD)
- Insomnia-related issues, often used as an off-label treatment due to its sedative properties.
It's important to note that Trazodone is more commonly used now for insomnia than depression, mainly because of its ability to help initiate and maintain sleep.
How does Trazodone help with these illnesses?
Trazodone, like Elavil, is an antidepressant medication that works by balancing the levels of serotonin in the brain. Serotonin plays a significant role in mood regulation and low levels are often associated with depression. Trazodone increases these serotonin levels thereby helping to alleviate symptoms of depression. Unlike Elavil which acts on multiple neurotransmitters including norepinephrine, trazodone primarily targets serotonin receptors making it less likely to cause certain side effects linked with increased norepinephrine such as high blood pressure or heart rate. Additionally, due to its unique mechanism of action and sedative properties, trazodone is also commonly used off-label for sleep disorders particularly when insomnia coexists with anxiety or depression. Therefore it may be chosen over multi-action drugs like Elavil when patients have difficulty sleeping or cannot tolerate other antidepressants.
How effective are both Elavil and Trazodone?
Both amitriptyline (Elavil) and trazodone have well-established histories in the treatment of depression, with FDA approvals dating back to 1961 and 1981 respectively. Amitriptyline is a tricyclic antidepressant while trazodone is classified as an atypical antidepressant, meaning they modulate different neurotransmitters for their effects.
Amitriptyline's effectiveness was directly studied against placebo in multiple clinical trials throughout the years, showing significant efficacy in managing symptoms of depression. Similar studies were carried out with Trazodone demonstrating comparable results. However, due to their side effect profiles which include drowsiness and anticholinergic effects such as dry mouth and constipation, both drugs are often not first-line treatments but can be considered when others fail or aren't tolerated.
In a 2009 review on amitriptyline it was found that although effective at combating depressive symptoms from the start of treatment its side-effect profile tended to be less favorable than newer-generation SSRIs or SNRIs. Despite this it remains widely used due to its lower cost and established history.
On the other hand, a meta-analysis conducted in 2017 demonstrated that while Trazodone has shown similar efficacy compared to other standard antidepressants for treating major depressive disorder it does hold an advantage by causing fewer sexual side-effects which are common among most modern-day antidepressants.
As standalone treatments both meds have robust data supporting their efficacy however co-prescription alongside another class of drug like SSRI/SNRI isn’t uncommon especially considering Trazadone’s unique pharmacology giving sedative properties which proves beneficial for patients suffering from insomnia along with depression.
Related trials for elavil and trazodone
Find Top Clinical Trials
Choose from over 30,000 active clinical trials.
At what dose is Elavil typically prescribed?
Oral dosages of Elavil typically begin at 75 mg/day for adults, though this can be increased up to a maximum dose of 150 mg/day depending on the patient's response and tolerability. Children and adolescents may be started on lower doses, around 10–25 mg/day. In either population, dosage adjustments can be made after several weeks if necessary based on the clinical response and tolerance level. The maximum dosage that should not be exceeded in any case is 300 mg/day.
On the other hand, Trazodone is usually prescribed starting at a dose of 150 mg per day for adults divided into smaller doses throughout the day or as a single dose taken before bedtime. This can eventually increase to a daily total of anywhere from 300-600mg depending upon its effectiveness and patient tolerance levels. For children and adolescents, the dosage will depend greatly upon their body weight which should always be determined by their healthcare provider.
At what dose is Trazodone typically prescribed?
Trazodone treatment typically begins at a dosage of 50-100 mg/day taken orally at bedtime. The dose can then be increased to up to 150 mg/day, divided into two doses, one in the mid-afternoon and another at bedtime. If necessary, for more severe cases of depression or anxiety, the maximum dose may reach up to 400 mg/day for outpatients and 600 mg/day for inpatients divided into multiple doses throughout the day. Such an increase would only be considered if there is no significant response to treatment after several weeks on a lower dose.
What are the most common side effects for Elavil?
Common side effects of Elavil (amitriptyline) and Trazodone can include:
- Drowsiness or fatigue
- Dry mouth
- Nausea, vomiting, and loss of appetite
- Constipation or diarrhea
- Blurred vision
- Increased heart rate
- Disorientation or confusion
- Unsteadiness leading to falls
- Lowered blood pressure upon standing (orthostatic hypotension) -Sexual dysfunction such as decreased libido, abnormal ejaculation, impotence in men.
Less common but more serious side effects may include seizures, abnormal heart rhythms. It's important to remember that everyone reacts differently to medications - what works well for one person might not work as effectively for another. Always consult your healthcare provider if you experience any adverse symptoms while taking these medications.
Are there any potential serious side effects for Elavil?
While both Elavil and Trazodone are medications used to treat depression, they can have different side effects. In rare cases, these may include:
- Thoughts of suicide or self-harm
- Signs of a severe allergic reaction: hives, difficulty breathing, swelling in the face or throat
- Skin reactions: fever, sore throat, burning eyes, skin pain - red or purple rash with blistering and peeling could be signs of serious skin conditions
- Vision problems: blurred vision or tunnel vision; eye pain/swelling; seeing halos around lights
- Cardiac symptoms: rapid heartbeats; feeling like your heart is fluttering in your chest; shortness of breath; sudden dizziness (like you might pass out) Low sodium levels - this can cause headaches, confusion, slurred speech/severe weakness/vomiting/loss of coordination/unsteadiness Severe nervous system reaction - rigid muscles/high fever/sweating/confusion/fast or uneven heartbeat/tremors/a faint-like feeling
In addition to these commonalities between two drugs' effects , it's important to know that each drug carries its own unique risks as well. Always consult with a medical professional before making decisions about medication changes.
What are the most common side effects for Trazodone?
Trazodone, another medication used to treat depression along with conditions like anxiety and insomnia, can potentially cause a different set of side effects. You may experience dry mouth or an unpleasant taste in your mouth as well as some constipation and diarrhea. It's also common for Trazodone users to encounter drowsiness and fatigue; hence it is often recommended to be taken before bed. Some people might notice mild headache or muscle ache too. More serious but less frequent side effects include low blood pressure, fainting, irregular heartbeat, blurred vision, confusion or disorientation. Additionally, nausea could occur at the beginning of treatment but generally improves over time. Remember that if you're considering Trazodone for its sleep-promoting benefits instead of Elavil due to any reason such as intolerable side-effects from Elavil etc., discuss these potential reactions with your healthcare provider first.
Are there any potential serious side effects for Trazodone?
While Trazodone is commonly prescribed for insomnia and depression, it's important to be aware of potential side effects. These may include:
- Signs of an allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Severe skin reactions like skin pain, red or purple rash that spreads with blistering and peeling
- Thoughts about suicide or hurting yourself
- A seizure (convulsions)
- Changes in mood or behavior including feeling agitated or restless
- Blurred vision, tunnel vision, eye pain or swelling
- Rapid heartbeat; irregular heart rhythm
- Low levels of sodium leading to headache, confusion slurred speech and/or severe weakness.
If you experience any of these symptoms while taking Trazodone, seek immediate medical attention.
Contraindications for Elavil and Trazodone?
Both Elavil and Trazodone, like many other antidepressants, may increase symptoms of depression in certain individuals. If you observe your depression intensifying or if there's an escalation in suicidal thoughts or behavior, please seek immediate medical care.
Neither Elavil nor Trazodone should be used if you are taking, or have recently taken monoamine oxidase inhibitors (MAOIs). It is crucial that your healthcare provider is made aware of all medications currently being taken by you; MAOIs require approximately 5 weeks to be eliminated from the body to prevent hazardous interactions with either Elavil or Trazodone.
How much do Elavil and Trazodone cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Elavil (25 mg) averages around $80, which works out to $2.60–5.30/day, depending on your dose.
- The price of 30 tablets of Trazodone (50 mg) averages is about $15, working out to approximately $0.50/day.
Thus, if you are in the higher dosage range for Elavil (i.e., 75 mg/day or higher), then brand-name Trazodone is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For the generic versions of Elavil (amitriptyline) and Trazodone:
- Amitriptyline (25mg tablets) is available in packs from 28 capsules and above, with approximate costs ranging from $4 to $10 total regardless the quantity, translating into a daily cost as low as $0.14 up to about $.35 per day if you are taking standard dosages between 50 and 150mg.
- Generic trazodone comes in various strengths such as 150mg costing roughly between $4-$20 for quantities starting at seven tables going up to hundreds making it anywhere from just pennies per day up to around $.70 depending on strength chosen and quantity purchased upfront.
Remember that while generic medications contain identical active ingredients they may have different inactive components than their branded counterparts; this can occasionally lead some patients experiencing differences in side effects or efficacy between brands vs generics; consult with your doctor before switching types.
Popularity of Elavil and Trazodone
Amitriptyline, also known by the brand name Elavil, was prescribed to approximately 1.6 million people in the USA in 2020. As a tricyclic antidepressant (TCA), amitriptyline accounted for around 5% of TCA prescriptions and just under 2% of overall antidepressant prescriptions. The prevalence of TCAs like amitriptyline has been gradually decreasing since their peak popularity in decades past due to the development of newer classes of antidepressants with fewer side effects.
On the other hand, trazodone was prescribed to nearly 8 million people in America during that same year. In terms of atypical antidepressants (medications not classified as SSRIs or other broad categories), trazodone is among the most commonly used and it accounts for over a quarter of all such prescriptions. Unlike TCAs, usage rates for drugs like trazodone have been rising steadily throughout recent years.
Conclusion
Both Elavil (amitriptyline) and Trazodone have a long history of use in treating depression and are supported by numerous clinical studies indicating their effectiveness. In some cases, these medications can be used together under the supervision of a healthcare professional, as they work differently to manage depressive symptoms. Elavil is primarily a tricyclic antidepressant that affects serotonin and norepinephrine levels in the brain while Trazodone is an atypical antidepressant which also acts on serotonin but has distinct effects on certain serotonin receptors.
Elavil is often employed as a first-line treatment for major depressive disorder due to its proven efficacy over many years. Trazodone may be used as adjunctive therapy to enhance the effects of other antidepressants such as Elavil or when patients haven't responded adequately to initial treatments.
Both drugs are available in generic form, providing cost savings for those paying out-of-pocket. An adjustment period may be necessary with both Elavil and Trazodone where full therapeutic benefits might not emerge immediately.
The side effect profiles between the two drugs are somewhat different: Both generally being well-tolerated, however, drowsiness tends to occur more frequently with Trazodone while dry mouth and constipation may happen more often with amitriptyline. It's vital that patients closely monitor their mood changes particularly when initiating treatment regimes including either drug; seeking medical advice promptly if any worsening depression or suicidal thoughts appear.
Other Trials to Consider
Popular Categories
Popular Guides
Learn More About These Treatments
Refrences
- Scharfetter, C. (1965). Vergiftung mit einem Antidepressivum. Archiv f�r Psychiatrie und Nervenkrankheiten Vereinigt mit Zeitschrift f�r die Gesamte Neurologie und Psychiatrie. Springer Science and Business Media LLC.http://doi.org/10.1007/bf00343771
- Fagiolini, A., Comandini, A., Dell’Osso, M. C., & Kasper, S. (2012, October 13). Rediscovering Trazodone for the Treatment of Major Depressive Disorder. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40263-012-0010-5
- McClure, E. W., & Daniels, R. N. (2021, January 13). Classics in Chemical Neuroscience: Amitriptyline. ACS Chemical Neuroscience. American Chemical Society (ACS).http://doi.org/10.1021/acschemneuro.0c00467
- Rosenberg, R. P. (2006, January). Sleep Maintenance Insomnia: Strengths and Weaknesses of Current Pharmacologic Therapies. Annals of Clinical Psychiatry. Portico.http://doi.org/10.1080/10401230500464711
- Rao, M., Deister, A., Laux, G., Staberock, U., Höflich, G., & Möller, H.-J. (1996, May). Low Serum Levels of Tricyclic Antidepressants in Amitriptyline- and Doxepin-Treated Inpatients with Depressive Syndromes are Associated with Nonresponse. Pharmacopsychiatry. Georg Thieme Verlag KG.http://doi.org/10.1055/s-2007-979552
- Sivolap, Y. P. (2017). Serotonin neurotrasmission and treatment options for depression. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Media Sphere Publishing Group.http://doi.org/10.17116/jnevro2017117111174-177
- Brogden, R. N., Heel, R. C., Speight, T. M., & Avery, G. S. (1981, June). Trazodone. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-198121060-00001
- Georgotas, A., Forsell, T. L., Mann, J. J., Kim, M., & Gershon, S. (1982, September 10). Trazodone Hydrochloride: A Wide Spectrum Antidepressant with a Unique Pharmacological Profile. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. Wiley.http://doi.org/10.1002/j.1875-9114.1982.tb03193.x