Amitriptyline vs Fluoxetine: side-by-side comparison
Amitriptyline (Tricyclic antidepressant (TCA)) and Fluoxetine (Selective serotonin reuptake inhibitor (SSRI)) 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 | Fluoxetine |
|---|---|---|
| Therapeutic class | Tricyclic antidepressant (TCA) | Selective serotonin reuptake inhibitor (SSRI) |
| CAS | 50-48-6 | 54910-89-3 |
| ATC | N06AA09 | N06AB03 |
| Molecular weight | 277.40 g/mol | 309.33 g/mol |
| Brands with this active ingredient | 1 | 1 |
What they share
Amitriptyline and Fluoxetine 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 Fluoxetine, 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. Fluoxetine: La fluoxétine inhibe sélectivement le transporteur de recapture de la sérotonine, augmentant la disponibilité synaptique de la sérotonine.
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… Fluoxetine: La fluoxétine est autorisée dans la dépression caractérisée (adulte et enfant à partir de 8 ans), le trouble obsessionnel compulsif, la boulimie nerveuse, le trouble panique et le trouble dysphorique prémenstruel.
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… Fluoxetine: Les effets indésirables fréquents comprennent nausées, céphalées, troubles du sommeil, troubles de la fonction sexuelle et diminution de l'appétit.
Questions fréquentes
Is Amitriptyline better than Fluoxetine? ▾
Amitriptyline and Fluoxetine are not "better or worse" — they treat different things. The sensible question is which fits your specific need.
Can Amitriptyline and Fluoxetine 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 Fluoxetine
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.