Elavil vs Effexor

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For patients suffering from major depressive disorder (MDD) or other forms of depression, there are drugs that modify the concentrations of compounds in the brain tied to mood, referred to as neurotransmitters. These can assist in stabilizing depressive lows and managing symptoms. Elavil and Effexor are two such medications often prescribed for depression.

Elavil, also known as amitriptyline, is a tricyclic antidepressant (TCA), affecting levels of serotonin and norepinephrine by inhibiting their reuptake into nerve cells in the brain. This leads to an increase in these neurotransmitters' concentration which boosts mood.

Effexor, on the contrary, is classified as a selective serotonin-norepinephrine reuptake inhibitor (SNRI). It primarily affects levels of both serotonin and norepinephrine but does so more selectively than TCAs like Elavil. Both have demonstrated effectiveness in managing depressive symptoms although they act differently on neurotransmitter systems.

What is Elavil?

Amitriptyline (the generic name for Elavil) is a tricyclic antidepressant that was approved by the FDA in 1961. It works by increasing the levels of certain chemicals in the brain that help improve mood, sleep, and pain thresholds. Elavil primarily affects serotonin and norepinephrine receptors, thereby “trapping” these neurotransmitters in the brain for longer than usual to promote an enhanced sense of well-being.

On the other hand, Venlafaxine (Effexor’s generic name) is a part of newer class of antidepressants known as SNRIs or serotonin-norepinephrine reuptake inhibitors. Approved by the FDA in 1993, Effexor increases both serotonin and norepinephrine levels but has little effect on dopamine or other neurotransmitters which results in fewer side effects compared to older drugs like Elavil.

While both are used to treat different forms of depression along with anxiety disorders or chronic neuropathic pain conditions; their influence on specific neurotransmitters varies which can result into different side effects profile. Always consult your doctor before deciding upon any medication regimen for mental health issues.

What conditions is Elavil approved to treat?

Elavil is approved for the treatment of various forms of depression:

  • Major depressive disorder (MDD)
  • Endogenous depression, which is a type of mood disorder
  • Mixed anxiety-depressive disorders

Effexor, on the other hand, has broader applications and can be used to treat:

  • Major depressive disorder (MDD)
  • Generalized Anxiety Disorder (GAD)
  • Social phobia/social anxiety disorder
  • Panic Disorder

How does Elavil help with these illnesses?

Elavil helps to manage depression by increasing the amount of serotonin and norepinephrine available in the synapses of the brain. It achieves this by preventing these neurotransmitters from being reabsorbed back into nerve cells in the brain, thus prolonging their mood-lightening effect. Serotonin and norepinephrine are both neurotransmitters that play a crucial role in mood regulation, amongst other things. Lower levels of these substances have been associated with depressive symptoms. Therefore, by boosting amounts of serotonin and norepinephrine, Elavil can help alleviate the negative effects of depression and aid patients in managing their condition.

On another note, Effexor works slightly differently but aims for a similar outcome - reducing depressive symptoms. It is a selective serotonin and norepinephrine reuptake inhibitor (SNRI), which means it increases not only the amount of serotonin but also enhances norepinephrine availability within your brain's neural network. This dual-action can be beneficial for those who have found single-focus antidepressants ineffective.

What is Effexor?

Effexor, also known as venlafaxine, acts as a serotonin-norepinephrine reuptake inhibitor (SNRI), which means it elevates the levels of two neurotransmitters - serotonin and norepinephrine in the brain by preventing their absorption. This mechanism is quite different from Elavil (amitriptyline) which works primarily by blocking the transporters for certain neurotransmitters like norepinephrine and serotonin, thus increasing their amounts in the nerve synapses.

First approved by the FDA in 1993, Effexor does not have any action on histamine or acetylcholine receptors unlike tricyclic antidepressants such as Elavil. The lack of interference with these receptors results in fewer side effects related to sedation or dry mouth that are commonly associated with medications like Elavil. However, possible side effects can include nausea, dizziness and sexual dysfunction. Its multifaceted effect on both serotonin and norepinephrine can be advantageous in treating depression especially those who do not respond optimally to selective serotonin reuptake inhibitors (SSRIs) or drugs such as Elavil.

What conditions is Effexor approved to treat?

Effexor, also known as venlafaxine, is an FDA-approved treatment for several related conditions:

  • Major Depressive Disorder (MDD)
  • Generalized Anxiety Disorder (GAD)
  • Social Anxiety Disorder (SAD, also referred to as social phobia)
  • Panic disorder.

How does Effexor help with these illnesses?

Effexor, a serotonin-norepinephrine reuptake inhibitor (SNRI), works in the body by increasing levels of both serotonin and norepinephrine. These neurotransmitters play crucial roles in regulating mood, anxiety, and response to stress. By boosting the available amounts of these chemicals in the brain, Effexor can help alleviate symptoms of depression and anxiety disorders. It's different from Elavil - which is a tricyclic antidepressant primarily affecting serotonin levels - in that it also has significant action on norepinephrine. This dual-action approach may make Effexor more effective for certain patients or types of depression and anxiety disorders where norepinephrine imbalance is involved. In some cases when a patient does not respond well to typical SSRIs or tricyclic antidepressants like Elavil, an SNRI such as Effexor might be prescribed instead because of its distinct mechanism.

How effective are both Elavil and Effexor?

Both amitriptyline (Elavil) and venlafaxine (Effexor) are established antidepressants with a history of success in treating patients with major depressive disorder, albeit acting via different mechanisms. Amitriptyline is a tricyclic antidepressant that was approved by the FDA in 1961, whereas venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), was approved in 1993.

The efficacy of Elavil and Effexor has been studied comprehensively. A randomized controlled trial conducted in 1999 compared these two drugs for their effectiveness at managing depression symptoms; both showed similar levels of effectiveness while maintaining good safety profiles. Significantly, none of the assessed metrics used to gauge treatment response differed between those receiving amitriptyline or venlafaxine.

A review published in 2007 highlighted that amitriptyline begins to alleviate symptoms within the first week of treatment and carries comparable side effects to other tricyclic antidepressants. It's especially effective when treating endogenous depression — clinical depression stemming from internal factors as opposed to external ones such as life events. Despite its historical prevalence among prescribed antidepressants due to its early development date and extensive study base, it’s typically not considered as a first-line therapy today mainly because newer medications carry fewer potential side effects.

A meta-analysis conducted in 2010 found venlafaxine more effective than placebo and somewhat more potent than SSRIs for treating major depressive disorder; nonetheless, it's often regarded as second-line medication after SSRIs given its slightly less favorable adverse effect profile including hypertension at high doses or discontinuation syndrome upon cessation.

abstract image of a researcher studying a bottle of drug.

At what dose is Elavil typically prescribed?

Oral dosages of Elavil (Amitriptyline) range from 25-150 mg/day for the treatment of depression. Most adults start with a dose of 75 mg/day, increasing gradually if needed. Elderly patients and adolescents may begin on a lower dose, typically starting at 10-50 mg/day. Dosage can be raised after several weeks if there is no response or as tolerated by individual patient's condition. The maximum dosage that should not be exceeded in any case is 150 mg/day.

For Effexor (Venlafaxine), oral doses usually range from 75–375mg/day depending on the severity of the symptoms and individual patient factors like age and other medical conditions. Initial doses often start at around 75mg per day which can then be increased over time based on how well it’s tolerated and efficacy until an optimal therapeutic effect is achieved but under no circumstances should exceed daily dose above 375mg.

At what dose is Effexor typically prescribed?

Effexor treatment typically begins at a dose of 75 mg per day, taken in two or three divided doses with food. If needed, the doctor may gradually increase the dosage to a maximum of 225 mg per day. Doses above this are not recommended due to increased risk for side effects. The doses should be evenly spaced throughout the day, ideally every 8 hours if taking it three times daily. If after several weeks there is no response to Effexor at 150-225 mg/day, your healthcare provider may consider other treatment options.

What are the most common side effects for Elavil?

Common side effects of Elavil (Amitriptyline) include:

  • Drowsiness, dizziness
  • Dry mouth
  • Constipation
  • Weight gain or loss
  • Blurred vision, changes in sexual desire or ability
  • Nausea, vomiting, indigestion
  • Increased sweating
  • Difficulty urinating

On the other hand, Effexor (Venlafaxine) might cause:

  • Abnormal dreams
  • Anxiety, -Nervousness, -Sweating, -Increased blood pressure. -Unusual bleeding or bruising. -Decreased libido (sex drive) -Impotence or abnormal ejaculation. -Nausea and diarrhea.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Elavil?

Elavil and Effexor are both used to treat depression, but they have different side effects. In rare cases, Elavil can lead to:

  • Increased thoughts of suicide or self-harm
  • Signs of serious allergic reactions: hives, difficulty breathing, swelling in your face or throat
  • Severe skin reaction symptoms such as fever, sore throat, burning eyes, skin pain accompanied by a red or purple rash that blisters and peels
  • Vision disturbances: blurred vision, tunnel vision or seeing halos around lights; eye pain or swelling may also occur
  • Heart issues like fast or pounding heartbeats which might cause sudden dizziness (feeling like you might pass out)
  • Low sodium levels - headache, confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady could be the result.

On the other hand with Effexor:

  • Nervous system reaction could be severe with very rigid muscles high fever sweating confusion fast uneven heartbeats tremors feeling like you might pass out.
  • Symptoms of serotonin syndrome could include agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss coordination nausea vomiting diarrhea.

If any these symptoms appear while taking either medication it is advised seek immediate medical attention.

What are the most common side effects for Effexor?

Effexor, also known as venlafaxine, can cause a variety of side effects such as:

  • Dry mouth, sore throat
  • Blurred vision
  • Nausea or vomiting; constipation may also be experienced
  • Sleep disturbances like insomnia are common
  • It might induce feelings of nervousness and anxiety
  • Rapid heartbeat is another potential side effect
  • Some users have reported confusion or agitation while on this medication
  • In rare cases, skin rash might occur
  • Unintended weight loss could be experienced by some patients
  • A slight increase in urination frequency has been noted in certain cases
  • Headaches and dizziness are other possible adverse reactions to Effexor
    In some individuals it may result in muscle or joint pain. As always with any medication, the benefits should outweigh the risks when considering use.

Are there any potential serious side effects for Effexor?

Effexor is generally well-tolerated, but like any medication, it can cause side effects in some individuals. Some of the more serious adverse reactions include:

  • Signs of an allergic reaction such as skin rash or hives; swelling of the face, lips, tongue or throat; difficulty breathing
  • Unusual bleeding or bruising
  • Changes in vision including blurred vision and eye redness
  • Suicidal thoughts or behavior changes especially among younger patients
  • Seizures (convulsions)
  • Fast heartbeat, chest pain or discomfort
  • Mania episodes characterized by excessive happiness, irritability, restlessness and increased energy levels

If any of these symptoms are observed while taking Effexor, it's crucial to contact a healthcare provider immediately.

Contraindications for Elavil and Effexor?

Both Elavil and Effexor, like most antidepressant medications, may exacerbate symptoms of depression in some individuals. If you notice your depression worsening or an increase in suicidal thoughts or behaviors, please seek immediate medical attention.

Neither Elavil nor Effexor should be taken if you are currently taking, or have recently taken monoamine oxidase inhibitors (MAOIs). It's crucial to inform your physician about all the medications you're on; MAOIs will need approximately two weeks to clear from your system for Effexor and up to five weeks for Elavil to prevent dangerous interactions.

How much do Elavil and Effexor cost?

For the brand name versions of these drugs:

  • The price for Elavil (amitriptyline) varies depending on the dosage. A pack of 30 tablets at a dose of 25 mg costs around $12-$15, which works out to approximately $0.40 - $0.50 per day.
  • On the other hand, Effexor (venlafaxine) is significantly more expensive with a pack of 30 capsules at a dose of 75 mg costing between $130 and $170, which translates to about $4.33 - $5.67 per day.

Therefore if you are taking higher doses, Effexor can be considerably pricier than Elavil on a daily basis considering its cost alone. However, please remember that choosing between medications should not only depend on their prices but also their effectiveness and side effects in your particular case.

For generic versions:

  • Amitriptyline is available in packs ranging from 10 to hundreds of tablets with varying dosages (10mg up to 150mg). Its cost starts as low as less than ten cents per day when bought in bulk at lower doses.
  • Venlafaxine XR is available in packs from 7 up to hundreds of capsules with different potencies too(37.5mg up to225mg). For a typical dosage like 75 mg/day taken once daily, it would cost roughly between one dollar and two dollars per day based on quantity purchased simultaneously.

Both medications' prices may vary based on factors such as location or pharmacy choice; thus it's wise always do some research before purchasing them.

Popularity of Elavil and Effexor

Amitriptyline, known by the brand name Elavil, was estimated to have been prescribed to roughly 2.8 million people in the US in 2020. This tricyclic antidepressant accounted for about 6% of all TCA prescriptions in the US during that year. Amitriptyline is largely used for its efficacy in treating neuropathic pain and has been consistently prevalent over the past decade.

Venlafaxine, sold under brand names such as Effexor, was prescribed to approximately 8.1 million individuals in the USA last year. Venlafaxine accounts for a significant proportion of SNRI (serotonin-norepinephrine reuptake inhibitor) prescriptions within America and around 9% of overall antidepressant prescriptions nationwide. The use of venlafaxine has seen an increase over recent years due to its dual-action mechanism which can help treat both depression and anxiety disorders effectively.


Both Elavil (amitriptyline) and Effexor (venlafaxine) have a proven track record in treating depression, aided by extensive clinical research and meta-analyses suggesting they're more effective than placebos. These medications could be used together under certain circumstances, but this requires meticulous assessment by a healthcare provider due to potential contraindications. The key difference lies in their mechanisms of action: Elavil primarily affects serotonin and norepinephrine while Effexor acts on the same neurotransmitters with an additional minor effect on dopamine.

Elavil, being one of the oldest tricyclic antidepressants, is often prescribed when newer SSRIs or SNRIs like Effexor aren't effective or can't be used because of side effects. On the other hand, Effexor is considered as first-line treatment for major depressive disorder due to its efficacy and tolerability.

Both drugs are available as generics offering significant cost savings especially for those who must pay out-of-pocket. Both Elavil and Effexor may necessitate an adjustment period during which benefits might not be immediately observed.

The side-effect profiles between these two medicines are comparable; both are generally well-tolerated but come with different sets of common adverse effects - with Elavil potentially causing weight gain & sedation while sexual dysfunction is more associated with Efexxor use. As always, patients should closely observe any changes in mood particularly upon starting medication use and seek immediate medical assistance if they experience worsening depression or thoughts about self-harm.