How Are Amitriptyline And Effexor Different? (+3 Points)

By Ivan Kahwa

Page last updated: 30/01/2024 | Next review date: 30/01/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

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In this article, we will explore the key differences between Effexor and amitriptyline, the differences in their classes, mechanism of action, side effects and usage. How to select the best treatment option out of the two medications will also be discussed.

How are amitriptyline and Effexor different?

Although amitriptyline and Effexor (venlafaxine) are both used to treat depression and related disorders, they belong to different classes of antidepressants. Amitriptyline and Effexor have distinct differences in their:

Class of medication
Mechanism of action
Side effects
Pharmacological uses
Dosage and administration

Amitriptyline and Effexor are not taken or prescribed together due to the risk of increased side effects. However, if you are prescribed any of these two medications for your condition then you need to consult your healthcare provider regarding any queries you have related to these two medications.

Class of medication

Amitriptyline and Effexor belong to different classes of antidepressants, each having its distinct mechanism of action. Amitriptyline is the generic for Elavil. It belongs to the class of tricyclic antidepressants (TCA). Drugs belonging to this class have a wider range of effects on the neurotransmitters. TCAs are an older class of antidepressants (1).

On the other hand, Effexor is a brand of venlafaxine that belongs to the class of serotonin-norepinephrine reuptake inhibitors (SNRI). These drugs have more targeted action on the specific neurotransmitters (2). SNRIs are a rather newer class of antidepressants.

Mechanism of action

Tricyclic antidepressants such as amitriptyline inhibit the reabsorption of neurotransmitters such as serotonin and norepinephrine. This inhibition of the reuptake of these neurotransmitters increases their levels in the brain. In addition to this, amitriptyline also binds to some other receptors in the brain such as histamine receptors or muscarinic receptors (3).

Amitriptyline takes about a week to reach the full extent of its effects.

Effexor is the brand name of venlafaxine, which belongs to the class of serotonin-norepinephrine reuptake inhibitors. Effexor potentiates the inhibition of the reuptake of serotonin and norepinephrine causing these neurotransmitters to stay in the synaptic cleft and continue transmitting signals (4).

Effexor does not cause any additional effects on any other receptors, unlike amitriptyline. It has a more targeted action as compared to amitriptyline.

Side effects

The side effects profile of Effexor and amitriptyline is slightly different due to their mechanism of action (5) (6).

Side effect	Amitriptyline (TCA)	Effexor (SNRI)
Anticholinergic effects	Common	Less prominent compared to TCA
Weight gain	Possible	Possible but generally less than TCA
Cardiovascular effects	May cause changes in heart rate, orthostatic hypotension	Possible increase in blood pressure, especially at higher doses
Sexual effects	Can cause sexual dysfunctioning	May impact sexual function
Withdrawal symptoms	May have withdrawal symptoms if stopped abruptly	Can cause withdrawal symptoms if discontinued abruptly
Gastrointestinal issues	Constipation or diarrhoea, nausea	Nausea, possible gastrointestinal disturbances
Sedation	Common	can cause drowsiness but is generally less sedating at low doses

Pharmacological uses

Amitriptyline and Effexor are used for several purposes. Their indications differ due to differences in their mechanism of action (7) (8).

Medications	Effexor	Amitriptyline
FDA approved uses	Major depressive disorder Social anxiety disorder General anxiety disorder Panic disorder	Major depressive disorder Neuropathic pain Migraine Prophylaxis
Non-FDA approved uses	Obsessive Compulsive disorder Post-traumatic stress disorder	Anxiety disorder Fibromyalgia Insomnia Some chronic pain conditions

Dosage and administration

When taking Effexor, its daily dose is divided into two to three divided doses that are to be taken throughout the day. It is not to be taken all at once. However, its extended-release dosage form is to be taken once daily. The starting dose of Effexor is lower as compared to amitriptyline. It can be taken with or without food (9).

On the other hand, amitriptyline has a comparatively higher starting dose. Amitriptyline is taken once daily and the dose depends upon the condition of the patient. The starting dose is low and then gradually increased to help the body adjust better to its effects (3).

Amitriptyline is available in oral tablet forms and is usually taken before bed due to the sedative effects of amitriptyline.

How to choose between Effexor and amitriptyline?

If you have to choose the best medication out of the two antidepressants i.e., Effexor and amitriptyline, then certain factors are to be considered. Even if both these are antidepressants, they differ in many aspects which leads to different indications for the two medications. The following factors are to be considered if you want to select the best possible option.

Frequency and severity of condition
Side effect profile
Individual’s response
Underlying health condition
Patient preferences
Cost and availability

Consulting healthcare provider

Effexor and amitriptyline have different uses. You need to consult your healthcare provider to consider every single aspect in order to make the best possible decision. These two medications interact differently with other drugs and medical conditions.

Your doctor will need to properly analyze your condition and take your past medical history to make the proper diagnosis. Considering your condition, your doctor will have to select the best medication out of the available options to ensure maximum effectiveness.

In my opinion, amitriptyline and Effexor are generally antidepressants but they belong to different classes of drugs. This is the basic reason for all the differences between the two antidepressants. Due to differences in their drug class and mechanism of action, Effexor and amitriptyline differ in their usage and administration as well.

Selecting the most appropriate drug for the treatment of your condition is a critical decision that should be taken by an experienced healthcare provider.

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References

1.-

Gillman PK. Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. Br J Pharmacol. 2007 Jul;151(6):737-48. [PMC free article] [PubMed] [Reference list]

2.-

Higuchi, T., Kamijima, K., Nakagome, K., Itamura, R., Asami, Y., Kuribayashi, K., & Imaeda, T. (2016). A randomized, double-blinded, placebo-controlled study to evaluate the efficacy and safety of venlafaxine extended release and a long-term extension study for patients with major depressive disorder in Japan. International clinical psychopharmacology, 31(1), 8–19. https://doi.org/10.1097/YIC.0000000000000105

3.-

Thour, A. (2023, July 18). Amitriptyline. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK537225/

4.-

Fenli S, Feng W, Ronghua Z, Huande L. Biochemical mechanism studies of venlafaxine by metabonomic method in rat model of depression. Eur Rev Med Pharmacol Sci. 2013 Jan;17(1):41-8. PMID: 23329522.

5.-

Karacostas, V., & Crosby, P. R. (2008, January 1). Psychiatric Pharmacotherapy. Elsevier eBooks. https://doi.org/10.1016/b978-032304073-0.10039-1

6.-

Brueckle, M. S., Thomas, E. T., Seide, S. E., Pilz, M., Gonzalez-Gonzalez, A. I., Nguyen, T. S., Harder, S., Glasziou, P. P., Gerlach, F. M., & Muth, C. (2020). Adverse drug reactions associated with amitriptyline – protocol for a systematic multiple-indication review and meta-analysis. Systematic reviews, 9(1), 59. https://doi.org/10.1186/s13643-020-01296-8

7.-

Radley DC, Finkelstein SN, Stafford RS. Off-label prescribing among office-based physicians. Arch Intern Med. 2006 May 08;166(9):1021-6. [PubMed] [Reference list]

8.-

Sansone, R. A., & Sansone, L. A. (2014). Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison. Innovations in clinical neuroscience, 11(3-4), 37–42.

9.-

Cowen, P. J. (1998, January 1). Psychopharmacology. Elsevier eBooks. https://doi.org/10.1016/b0080-4270(73)00248-0

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Diseases & Conditions

How are amitriptyline and Effexor different? (+3 points)