Compare doxepin vs. Vivactil

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

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doxepin

Prescription only

Vivactil (protriptyline)

Prescription only
Treats depression and anxiety.

doxepin can treat depression and anxiety, but it's not a first choice medication because of its many side effects.

Improves your mood.

Vivactil (protriptyline) is part of the first choice of medicines for depression, but it can cause problems with your heartbeat and change your sex drive.

Upsides
  • doxepin has been consistently shown to improve symptoms of depression and anxiety.
  • doxepin has been used to treat depression for over forty years.
  • Vivactil (protriptyline) is part of the first choice medicines for treating depression.
  • Compared to similar medicines, Vivactil (protriptyline) is less likely to make you feel sleepy.
  • Available in generic.
Downsides
  • doxepin can make you very sleepy. Try taking it at bedtime if you need to be alert during the day.
  • You shouldn't drink alcohol with doxepin. It can worsen side effects like drowsiness.
  • You have to take it daily, especially if you are feeling better, for the medicine to do its job.
  • It can have more side effects than other antidepressants, like weight gain and increased appetite, decreased libido, and sleepiness.
  • It's not unusual for people to try different antidepressants until they find one that works for them.
  • Vivactil (protriptyline) can lower your sex drive more than some other similar medicines.
  • Because Vivactil (protriptyline) can cause dizziness, people age 65 and older need to take precautions when taking Vivactil (protriptyline).
  • Vivactil (protriptyline) can worsen heart conditions. If you have a history of heart problems, you may need to have regular testing for your heart.
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Dosage forms
  • Pill
  • Liquid
  • Pill
Price
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Reviews
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Side effects
The doxepin FDA package insert doesn’t have numbers about how common side effects are.
The Vivactil (protriptyline) FDA package insert doesn’t have numbers about how common side effects are.
Risks and risk factors
  • Suicidal thoughts or behavior
    • Age 24 years or under
  • Unmasking of bipolar disorder
    • Bipolar disorder
  • Serotonin syndrome
    • Taking MAOIs (monoamine oxidase inhibitors)
  • Heart problems
    • History of heart disease
    • Adults over 65
    • Electrolyte imbalance
  • Sleepiness
    • Adults 65 years or older
    • Taking other medicines that cause drowsiness (antihistamines, sleep medications, narcotic pain medications)
    • Alcohol
  • Dizziness and falls
    • Age 65 years or older
See more detailed risks and warnings
  • Higher risk of suicide
    • Under age 24
  • Possible bipolar disorder
  • Heart problems
    • History of heart disease
    • Overactive thyroid
  • Higher risk of seizures
    • History of seizures
  • Changes in blood pressure
    • High blood pressure
See more detailed risks and warnings