amitriptyline vs doxepin
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of amitriptyline and doxepin. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
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Amitriptyline is a medicine used to treat depression. It may take up to 30 days to feel the full effect.
Doxepin is a medicine that can help you stay asleep. It belongs to a class of drugs called tricyclic antidepressants.
Amitriptyline is used to relieve the symptoms of depression. It works best for a type of depression called endogenous depression. This is depression that comes from within, rather than being caused by outside events.
Doxepin is used to treat insomnia, which means you have trouble staying asleep. It can help you sleep better if you have problems with waking up during the night. This medicine has been tested for up to 3 months.
Amitriptyline belongs to a class of drugs called tricyclic antidepressants (TCAs). It works by increasing the levels of certain chemicals in your brain. These chemicals help improve your mood.
Doxepin works by affecting certain natural chemicals in the brain that help regulate sleep. It helps to keep you asleep throughout the night. It is a low dose formulation of a tricyclic antidepressant.
- • Drowsiness
- • Dizziness
- • Weakness
- • Fatigue
- • Headache
- • Feeling sleepy or drowsy
- • Feeling sick to your stomach
- • Upper respiratory tract infection (like a cold)
- Pain 1,565
- Nausea 1,434
- Headache 1,381
- Fatigue 1,371
- Dyspnoea 1,340
- Toxicity To Various Agents 801
- Completed Suicide 613
- Fatigue 599
- Nausea 557
- Pain 527
Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Your doctor should closely monitor you for worsening depression or unusual changes in behavior. Amitriptyline is not approved for use in children.
After taking doxepin, some people have done things like driving a car while not fully awake. You might not remember doing it. This can be dangerous, so tell your doctor right away if this happens. Doxepin may also worsen depression or cause suicidal thoughts. Tell your doctor if you notice any new or worsening symptoms of depression.
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if amitriptyline will harm your unborn baby. Amitriptyline can pass into breast milk.
Taking doxepin late in pregnancy may cause problems for the newborn baby, like trouble breathing or feeding. Breastfeeding is not recommended while taking this medicine.
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How to Read This amitriptyline vs doxepin Comparison
amitriptyline is classified in the Tricyclic Antidepressant (TCA) drug class, while doxepin sits within the Tricyclic Antidepressant (TCA) class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, amitriptyline has 7,091 submissions while doxepin has 3,097. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for amitriptyline or doxepin.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.