Compare Elavil vs. Prozac

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Elavil
(Amitriptyline)

Prozac
(Fluoxetine)

Improves mood and relieves certain kinds of pain. Elavil (Amitriptyline) is an older antidepressant that's sometimes used to treat pain and sleep problems, but it can have more side effects than similar medications.Improves mood and helps you relax. Prozac (Fluoxetine) is good for treating depression and anxiety. It's more energizing than other antidepressants, but may not be the best choice for people who have trouble sleeping.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.466101694915254Elavil
Reviews for Elavil (Amitriptyline)
52%
of people say Elavil (Amitriptyline) is worth it
34%
say it works well
23%
say it's a big hassle
Reviews for Prozac (Fluoxetine)
61%
+9% vs. Elavil (Amitriptyline)
40%
+6% vs. Elavil (Amitriptyline)
16%
+7% vs. Elavil (Amitriptyline)
Side effects
ElavilProzac

The Elavil FDA package insert doesn’t have numbers about how common side effects are.

More about Elavil side effects »
  • Rash 57%
  • Sleep difficulty 20%
  • Nausea 18%
  • Muscle weakness 12%
  • Drowsiness 10%
  • Tremor 9%
  • Dry mouth 9%
  • Lower sex drive 9%
  • Loss of appetite 7%
  • Anxiety 7%
More Prozac side effects »
How it works
ElavilProzac
Elavil (Amitriptyline) is a tricyclic antidepressant (TCA). Researchers don't know exactly how it works. It may change serotonin and norepinephrine activity in the brain, which regulates mood and pain perception. It also has sedative effects.Prozac (Fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.
Type of medication
ElavilProzac
Antidepressant
Tricyclic antidepressant (TCA)
Prescription only
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Available as
ElavilProzac
  • Pill
  • Pill
  • Delayed release capsule
  • Liquid
Used for (click to learn more)
ElavilProzac
How well it works for depression
The free Iodine Start program helps people track how well they are improving, and find the right antidepressant faster.
The free Iodine Start program (personal reports and coaching) is currently only for antidepressants. For now, you can read our pharmacist info about this medication.Learn more about Elavil (Amitriptyline)

After 4 weeks using Start and Prozac (Fluoxetine), here’s how much better people feel.

Risk factors for serious side effects
ElavilProzac
  • Age 24 years or younger
  • History of bipolar disorder
  • At risk for bipolar disorder
  • History of cardiovascular disease
  • Age 65 years or older
  • Age 65 years or older
Detailed Elavil (Amitriptyline) risks & warnings »
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Prozac (Fluoxetine) suddenly
  • History of heart problems
  • History of liver problems
  • Drug interactions
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
    Detailed Prozac (Fluoxetine) risks & warnings »
    Pregnancy category
    ElavilProzac
    CFDA pregnancy category (Weigh risks vs. benefits)

    Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

    See the FDA package insert
    CFDA pregnancy category (Weigh risks vs. benefits)

    Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

    See the FDA package insert
    Alcohol
    No specific alcohol-related info.No specific alcohol-related info.
    Food
    No specific food-related info.
    • Take in the morning with food to avoid side effects.
    Kidneys and liver
    No specific kidneys and liver-related info.No specific kidneys and liver-related info.
    Sex
    No specific sex-related info.
    • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
    • Prozac (Fluoxetine) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
    Sleep
    • Low doses of Elavil (Amitriptyline) start working in 45 minutes to help you sleep better.
    • Can cause dizziness, drowsiness, constipation, and weight gain.
    • Stopping Prozac (Fluoxetine) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
    Weight
    • It's more likely to cause sleepiness, nausea, constipation, diarrhea, and weight gain (1 to 5 pounds) than other antidepressants.
    • Can cause dizziness, drowsiness, constipation, and weight gain.
    No specific weight-related info.
    Upsides and benefits
    ElavilProzac
    • Low doses work well to treat certain kinds of chronic pain. It can take 2 weeks to feel the full effects of the medication.
    • Low doses of Elavil (Amitriptyline) start working in 45 minutes to help you sleep better.
    • Six out of every ten people who use an antidepressant for the first time find that it works for them.
    • Effective at relieving depression and anxiety symptoms.
    • Lowers relapse rates of depression and bulimia nervosa.
    • Causes less sleepiness than other antidepressants.
    • It's more energizing than other antidepressants, so it's good for people who have low energy.
    • It has been used to treat depression for a long time, so there's a lot of information available about how it works and how safe it is.
    • Six out of ten people who use an antidepressant for the first time find that it works for them.
    Downsides and risks
    ElavilProzac
    • When used for depression, Elavil (Amitriptyline) causes more side effects and has a higher risk of overdose than other antidepressants. It's usually used when other medications haven't worked.
    • It's more likely to cause sleepiness, nausea, constipation, diarrhea, and weight gain (1 to 5 pounds) than other antidepressants.
    • People age 65 and older have a higher risk for this medication's side effects.
    • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people age 24 and younger.
    • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
    • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
    • Can increase feelings of anxiety or cause headaches during the first few weeks of taking it. These effects should go away over time.
    • More likely than other antidepressants to interact with other medications you're taking.
    • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people younger than 24.
    • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
    Tips from our pharmacists for people taking the medication
    ElavilProzac
    • Take at bedtime to avoid some of its side effects.
    • Can cause dizziness, drowsiness, constipation, and weight gain.
    • Stop taking it slowly to avoid getting withdrawal symptoms.
    • Tell your doctor if you notice sudden mood changes or unusual thoughts.
    • Take in the morning with food to avoid side effects.
    • Takes about 8 to 12 weeks to see the medication's full effects on your mood.
    • Stop taking it slowly to avoid getting withdrawal symptoms.
    • Tell your doctor if you notice sudden mood changes or unusual thoughts.
    Learn more
    More about ElavilSide effectsReviews & ratingsAlternativesFDA package insert
    More about ProzacSide effectsReviews & ratingsAlternativesFDA package insert