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Amitriptyline vs Sertraline: side-by-side comparison

Amitriptyline (Tricyclic antidepressant (TCA)) and Sertraline (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 Sertraline
Therapeutic class Tricyclic antidepressant (TCA) Selective serotonin reuptake inhibitor (SSRI)
CAS 50-48-6 79617-96-2
ATC N06AA09 N06AB06
Molecular weight 277.40 g/mol 306.2 g/mol
Brands with this active ingredient 1 2

What they share

Amitriptyline and Sertraline 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 Sertraline, 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. Sertraline: La sertraline bloque sélectivement la recapture de la sérotonine (5-HT) par le neurone présynaptique, ce qui augmente la concentration de sérotonine dans la fente synaptique.

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… Sertraline: La sertraline est autorisée dans plusieurs indications psychiatriques chez l'adulte : dépression caractérisée, trouble panique avec ou sans agoraphobie, trouble obsessionnel compulsif (TOC), état de stress post-traumatiq…

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… Sertraline: Les effets indésirables fréquents comprennent nausées, diarrhée, insomnie, troubles de la fonction sexuelle, sécheresse buccale et sudation, surtout durant les premières semaines.

Questions fréquentes

Is Amitriptyline better than Sertraline?

Amitriptyline and Sertraline are not "better or worse" — they treat different things. The sensible question is which fits your specific need.

Can Amitriptyline and Sertraline 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 Sertraline

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.