Compare Lexapro vs. Elavil

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

Lexapro
(Escitalopram)

Elavil
(Amitriptyline)

Improves mood and helps you relax. Lexapro (Escitalopram) is good for treating depression and anxiety. Might be less likely to cause side effects than some antidepressants, but not the best choice for people with heart or liver problems.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.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.832985386221294Lexapro
Reviews for Lexapro (Escitalopram)
59%
of people say Lexapro (Escitalopram) is worth it
46%
say it works well
15%
say it's a big hassle
Reviews for Elavil (Amitriptyline)
52%
7% vs. Lexapro (Escitalopram)
34%
12% vs. Lexapro (Escitalopram)
23%
8% vs. Lexapro (Escitalopram)
Side effects
LexaproElavil
  • Ejaculation disorder 12%
  • Ejaculation disorder (primarily ejaculatory delay) 11%
  • Sleep difficulty 10%
  • Nausea 10%
  • Diarrhea 9%
  • Headache 7%
  • Drowsiness 6%
  • Fatigue 6%
  • Dizziness 5%
  • Lower sex drive 5%
More Lexapro side effects »

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

More about Elavil side effects »
How it works
LexaproElavil
Lexapro (Escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.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.
Type of medication
LexaproElavil
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Antidepressant
Tricyclic antidepressant (TCA)
Prescription only
Available as
LexaproElavil
  • Pill
  • Liquid
  • Pill
Used for (click to learn more)
LexaproElavil
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.

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

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)
Risk factors for serious side effects
LexaproElavil
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Lexapro (Escitalopram) suddenly
  • Higher dose
  • History of heart problems
  • History of liver problems
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
    Detailed Lexapro (Escitalopram) risks & warnings »
    • 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 »
    Pregnancy category
    LexaproElavil
    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
    • Take with food to avoid upset stomach.
    No specific food-related info.
    Kidneys and liver
    No specific kidneys and liver-related info.No specific kidneys and liver-related info.
    Sex
    • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
    • Lexapro (Escitalopram) 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.
    No specific sex-related info.
    Sleep
    • Stopping Lexapro (Escitalopram) 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.
    • Low doses of Elavil (Amitriptyline) start working in 45 minutes to help you sleep better.
    • Can cause dizziness, drowsiness, constipation, and weight gain.
    Weight
    • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
    • 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.
    Upsides and benefits
    LexaproElavil
    • Effective at relieving depression and anxiety symptoms.
    • Lowers relapse rates of depression.
    • Causes less sleepiness than some other antidepressants.
    • Six out of ten people who use an antidepressant for the first time find that it works for them.
    • 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.
    Downsides and risks
    LexaproElavil
    • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
    • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
    • Can cause an irregular heartbeat if you take a high dose (20 mg a day, or more).
    • Not a good option for you if you have heart or liver problems.
    • 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, and might have side effects you really don't like. You might need to try a few different medicines until you find one that works for you and that you can tolerate.
    • 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.
    Tips from our pharmacists for people taking the medication
    LexaproElavil
    • Take with food to avoid upset stomach.
    • 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.
    • 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.
    Learn more
    More about LexaproSide effectsReviews & ratingsAlternativesFDA package insert
    More about ElavilSide effectsReviews & ratingsAlternativesFDA package insert