Two medicines, side by side
Desipramine vs amitriptyline
Desipramine and amitriptyline are both labeled for depression. Drugs@FDA records approvals of desipramine since 1964 and of amitriptyline since 1961. Pharmacies paid $0.276 per desipramine 75 mg tablet and $0.03 per amitriptyline HCl 10 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the desipramine FDA label on DailyMed (effective July 9, 2025); the amitriptyline FDA label on DailyMed (effective September 8, 2026).
Highlights of the desipramine record
Desipramine (Norpramin) · label of July 9, 2025
Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of desipramine hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
Used for
From the label: indicationsDesipramine hydrochloride tablets, USP are indicated for the treatment of depression.
On the market
- Earliest approval on file
- November 20, 1964
- Generic labelers
- 9 labelers
- Pharmacy cost
- $0.276 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 6
Highlights of the amitriptyline record
Amitriptyline (Elavil) · label of September 8, 2026
Suicidality and Antidepressant Drugs: Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of amitriptyline hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
Used for
From the label: indicationsFor the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than are other depressive states.
On the market
- Earliest approval on file
- April 7, 1961
- Generic labelers
- 34 labelers
- Pharmacy cost
- $0.03 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Source: FDA drug labels via openFDA (Desipramine label of July 9, 2025, Amitriptyline label of September 8, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do desipramine and amitriptyline differ on the record?
Both are in FDA's class tricyclic antidepressants.
Both labels carry a boxed warning; the records quote them.
Generics: desipramine since 1987; amitriptyline since 1976 (Drugs@FDA).
| Desipramine | Amitriptyline | |
|---|---|---|
| Labeled for | Depression | Depression |
| Pharmacologic class | Tricyclic Antidepressant | Tricyclic Antidepressant |
| How it works (label) | n/a | in man is not known. It is not a monoamine oxidase inhibitor and it does not act primarily by stimulation of the central nervous system. |
| Half-life (label) | n/a | n/a |
| Earliest approval on file (Drugs@FDA) | November 20, 1964 | April 7, 1961 |
| First generic approved | June 5, 1987 | November 16, 1976 |
| Generic labelers (NDC) | 9 labelers | 34 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.276 per tablet (Desipramine 75 mg tablet) | $0.03 per tablet (Amitriptyline HCl 10 mg tablet) |
| 12-month price change | -16% | -19% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 6 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 274 | 17,441 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Desipramine label, warningsIf concomitant use of desipramine hydrochloride tablets with other serotonergic drugs including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, and St. John’s Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome particularly during treatment initiation and dose increases.
Amitriptyline label, warningsIf concomitant use of amitriptyline hydrochloride with other serotonergic drugs, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, and St. John’s Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases.
Source: FDA drug labels via openFDA
What next?
- Alternatives to desipramine
- every medicine labeled for the same conditions