amitriptyline vs sertraline
Side-by-side comparison of amitriptyline and sertraline. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
Recommendation: Your doctor may need to adjust your dose or watch you closely for increased side effects.
Elavil
Zoloft
Amitriptyline is a medicine used to treat depression. It may take up to 30 days to feel the full effect.
Sertraline is a medicine used to treat depression and other mental health conditions. It helps balance chemicals in your brain to improve your mood and reduce anxiety.
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.
Sertraline is used to treat major depressive disorder in adults. This means it can help with ongoing sadness or loss of interest in things. It also treats obsessive-compulsive disorder (OCD), where you have unwanted thoughts or behaviors that you can't control. Sertraline can also treat panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and social anxiety disorder.
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.
Sertraline is a selective serotonin reuptake inhibitor (SSRI). It works by increasing the amount of serotonin in your brain. Serotonin is a chemical that helps regulate mood, and by blocking its reabsorption, sertraline helps improve mood and reduce symptoms of depression and anxiety.
- • Drowsiness
- • Dizziness
- • Weakness
- • Fatigue
- • Headache
- • Nausea
- • Diarrhea
- • Headache
- • Insomnia
- • Dizziness
- Pain 1,564
- Feeling sick to your stomach 1,434
- Head pain 1,380
- Tiredness 1,369
- Shortness of breath 1,340
- Feeling sick to your stomach 5,757
- Feeling very tired 5,244
- Loose, watery stools 4,654
- Pain in your head 4,407
- Feeling lightheaded or unsteady 4,121
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.
Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Watch closely for worsening depression, unusual behavior, or thoughts of suicide. Sertraline is not approved for treating depression in children.
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.
Tell your doctor if you are pregnant or plan to become pregnant. Sertraline may affect your baby. Talk to your doctor about the risks and benefits of taking sertraline during pregnancy and breastfeeding.
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How to Read This amitriptyline vs sertraline Comparison
amitriptyline is classified in the Tricyclic Antidepressant (TCA) drug class, while sertraline sits within the Selective Serotonin Reuptake Inhibitor (SSRI) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. 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 7,087 submissions while sertraline has 24,183. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to sertraline slows down the liver's ability to process amitriptyline. this can cause amitriptyline to build up to higher levels in your body.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between amitriptyline and sertraline - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.