Amitriptyline vs Lexapro - Comparison of Differences & Uses


It is a medication that belongs to a group of drugs called tricyclic antidepressants (brand names Vanatrip, Elavil, Endep).

This medication works on the central nervous system to increase the level of certain chemicals in your brain and improve depression symptoms.

It was first approved by the US Food and Drug Administration in 1983.


It is used to treat nerve pain caused by:

  • treatments for cancer;
  • pain associated with human immunodeficiency virus;
  • injuries;
  • shingles (postherpetic neuralgia);
  • amputation (phantom limb);
  • diabetes.

Also, it is used for treating bedwetting (nocturnal enuresis) in children aged six years and over and migraine prevention.


The usual recommended dose is 25 mg for seniors and 100-300 milligrams for most adult patients. The initial recommended dose is between 50-100 mg.

Children under age 18 should not take this tricyclic antidepressant, however, in rare cases, a healthcare specialist may decide that the benefits outweigh the risks. It is not recommended for people with certain heart conditions.

Side Effects and Precautions

Common side effects may include:

  • upset stomach;
  • diarrhea;
  • vomiting;
  • constipation;
  • black tongue;
  • nausea;
  • appetite or weight changes;
  • unusual taste;
  • itching or rash;
  • mouth pain;
  • difficulty having an orgasm;
  • urinating less than usual;
  • impotence;
  • breast swelling (in men or women);
  • decreased sex drive.

Rare side effects may include:

  • a feeling like you might pass out;
  • unusual thoughts or behavior;
  • hallucinations;
  • sweating;
  • confusion;
  • nausea;
  • a seizure (convulsions);
  • pain spreading to your jaw or shoulder;
  • pounding heartbeats;
  • chest pain or pressure;
  • severe constipation;
  • painful or difficult urination;
  • red or swollen gums;
  • unusual bleeding;
  • trouble swallowing;
  • easy bruising;
  • mouth sores;
  • a sore throat;
  • sudden weakness or ill feeling.

Pregnancy & Breastfeeding

You should not take this tricyclic antidepressant if you are breastfeeding a baby since it can be excreted in the breast milk and may negatively affect the infant.

This drug falls into category C. There are no clinical studies to determine if it will harm your unborn baby. Therefore, consult your doctor before using this medication.

To make sure that this tricyclic antidepressant is safe for you, tell your healthcare provider if you have:

  • liver disease;
  • bipolar disorder (manic-depression) or schizophrenia;
  • heart disease;
  • a history of mental illness or psychosis;
  • diabetes (the medication may raise or lower blood sugar);
  • a history of stroke, heart attack, or seizures;
  • problems with urination;
  • glaucoma.
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Drug Interactions

Tell your healthcare provider about all the drugs you take, especially:

  • disulfiram (Antabuse);
  • ambien;
  • monoamine oxide inhibitors like phenelzine (Nardil) and selegiline (Emsam);
  • barbiturates such as phenobarbital;
  • cimetidine (Tagamet);
  • levocetirizine;
  • pseudoephedrine (Sudafed);
  • quinidine (Quinidex);
  • selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and citalopram (Celexa);
  • anti-arrhythmic drugs like propafenone (Rythmol) and flecainide (Tambocor).


It is the brand name of a medication called escitalopram, an antidepressant which is part of a group of drugs called selective serotonin reuptake inhibitors.

It works by increasing levels of serotonin, a monoamine neurotransmitter in the human brain that helps maintain mental balance in sufferers with depression or anxiety.

This selective serotonin reuptake inhibitor was first approved by the US FDA in 2002. It is currently produced by the Forest Laboratories, an American pharmaceutical company.


It is approved for the treatment of depression and generalized anxiety disorder.


This selective serotonin reuptake inhibitor is available in tablet form. The recommended dose is 10 mg once a day. Children younger than 12 should not take the medication.

Side Effects and Precautions

Common side effects may include:

  • sleep problems (insomnia);
  • feeling shaky or anxious;
  • excessive sweating;
  • weakness;
  • weight changes;
  • loss of appetite;
  • dry mouth;
  • drowsiness;
  • impotence;
  • dizziness;
  • decreased sex drive;
  • constipation;
  • yawning;
  • nausea;
  • difficulty having an orgasm.

Less common side effects may include:

  • tunnel vision;
  • seeing halos around lights;
  • a feeling like you might pass out;
  • unusual risk-taking behavior;
  • feeling unsteady;
  • eye pain or swelling;
  • fast or uneven heartbeats;
  • headaches;
  • loss of coordination;
  • feelings of extreme happiness or sadness;
  • very stiff muscles;
  • blurred vision;
  • slurred speech;
  • racing thoughts;
  • severe weakness;
  • tremors;
  • vomiting;
  • high fever;
  • confusion.


Most individuals should not consume alcoholic beverages during treatment with this selective serotonin reuptake inhibitor since alcohol can increase the nervous system side effects, including drowsiness, dizziness, and difficulty concentrating.

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Pregnancy & Breastfeeding

Using the medication during pregnancy may be the right option only if the benefits outweigh the risks to the unborn baby. Also, it passes into breast milk, therefore, contact your doctor before using it if you are breast-feeding a baby.

Drug Interactions

This selective serotonin reuptake inhibitor may negatively interact with other drugs, particularly:

  • tryptophan (also referred as L-tryptophan);
  • medicines to treat mood disorders, anxiety, or mental illness;
  • narcotic pain drugs, like – fentanyl or tramadol;
  • any other antidepressants;
  • ADHD medication, like – Adderall or Concerta;
  • a blood thinner, like – Coumadin or Jantoven;
  • lithium;
  • migraine headache medicines, like – rizatriptan or sumatriptan.

To make sure that this selective serotonin reuptake inhibitor is safe for you, tell your doctor if you have or ever had:

  • low levels of sodium in the blood;
  • seizures;
  • heart disease;
  • kidney disease;
  • drug addiction;
  • high blood pressure;
  • a bleeding disorder;
  • liver disease;
  • blood clotting disorder;
  • a stroke;
  • suicidal thoughts;
  • bipolar disorder (manic depression).

Bottom Line – Amitriptyline vs Lexapro

Amitriptyline (brand names Vanatrip, Elavil, Endep) is a tricyclic antidepressant that affects chemicals in the brain that may be unbalanced in sufferers with depression. It can also be prescribed by a doctor for chronic pain caused by:

  • damage to nerve endings in the limbs (peripheral neuropathy);
  • chronic (tension) headaches;
  • fibromyalgia;
  • back pain and neck pain;
  • arthritis.

Lexapro (active ingredient – escitalopram) belongs to a group of antidepressants called selective serotonin reuptake inhibitors which alter the levels of serotonin. It is prescribed for the acute treatment of generalized anxiety disorder in adult patients.



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