Amitriptyline vs Duloxetine: side-by-side comparison
Amitriptyline (Tricyclic antidepressant (TCA)) and Duloxetine (Serotonin-norepinephrine reuptake inhibitor (SNRI)) belong to different therapeutic classes and are rarely substitutes for each other. The comparison is useful when a single patient is weighing both options for adjacent or overlapping needs.
| Property | Amitriptyline | Duloxetine |
|---|---|---|
| Therapeutic class | Tricyclic antidepressant (TCA) | Serotonin-norepinephrine reuptake inhibitor (SNRI) |
| CAS | 50-48-6 | 116539-59-4 |
| ATC | N06AA09 | N06AX21 |
| Molecular weight | 277.40 g/mol | 297.41 g/mol |
| Brands with this active ingredient | 1 | 1 |
What they share
Amitriptyline and Duloxetine share the common regulatory framework for prescription active ingredients, bioequivalence standards for generics, and pharmacist oversight. Beyond that, points in common are limited.
Key differences
Amitriptyline acts by a different mechanism than Duloxetine, with indications that barely overlap. Comparing the two is useful when a clinician has mentioned both in the same context or the patient wants to understand why one was prescribed instead of the other.
Mechanisms compared
Amitriptyline: L'amitriptyline inhibe la recapture de la sérotonine et de la noradrénaline au niveau des synapses centrales, augmentant les concentrations synaptiques de ces deux neurotransmetteurs. Duloxetine: La duloxétine inhibe la recapture synaptique de la sérotonine et de la noradrénaline, avec un effet plus faible sur la dopamine.
Indications compared
Amitriptyline: L'amitriptyline est autorisée dans la dépression caractérisée, mais son usage contemporain est dominé par les indications hors AMM à faible dose : douleurs neuropathiques, fibromyalgie, céphalées de tension chroniques, p… Duloxetine: La duloxétine est autorisée dans la dépression caractérisée, le trouble anxieux généralisé, les douleurs neuropathiques périphériques diabétiques, la fibromyalgie, les douleurs musculosquelettiques chroniques (lombalgies…
Safety profile
Amitriptyline: Les effets indésirables fréquents reflètent les activités anticholinergique, antihistaminique et α1-bloquante : sécheresse buccale, constipation, dysurie, vision floue, sédation, prise de poids et hypotension orthostatiq… Duloxetine: Les effets indésirables fréquents comprennent nausées (surtout les 1 à 2 premières semaines), sécheresse buccale, céphalées, fatigue, troubles du sommeil et troubles de la fonction sexuelle.
Questions fréquentes
Is Amitriptyline better than Duloxetine? ▾
Amitriptyline and Duloxetine are not "better or worse" — they treat different things. The sensible question is which fits your specific need.
Can Amitriptyline and Duloxetine be combined? ▾
Whether they can be combined depends on the indications and the interaction profile of each. If both are in a single prescription, the prescriber has weighed it; in self-medication they should never be combined.
Do they have the same side-effect profile? ▾
No — they belong to different classes and have distinct side-effect profiles. Each has its own prescribing information.
Products with Amitriptyline
Products with Duloxetine
Les informations publiées sur ce site sont fournies à titre documentaire et pédagogique. Elles ne remplacent pas l'avis d'un professionnel de santé qualifié.