Table of ContentsView AllTable of ContentsUnderstanding TCAsWhat Is Nortriptyline?What Is Amitriptyline?Dosing GuidelinesSide Effects and SafetyGuidelines for Safe UseWho Should Avoid Them?Potential Drug InteractionsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Understanding TCAs
What Is Nortriptyline?
What Is Amitriptyline?
Dosing Guidelines
Side Effects and Safety
Guidelines for Safe Use
Who Should Avoid Them?
Potential Drug Interactions
Frequently Asked Questions
Pamelor is a brand name of nortriptyline.Conversely, amitriptyline is sold only as a generic.
However, nortriptyline and amitriptyline have some notable differences.
For example, amitriptyline is preferred for MDD when the side effect of mild sedation is desired, while nortriptyline is preferred when its stimulatory (energizing) effects are desired.
This article will provide an in-depth analysis of nortriptyline and amitriptyline, examining their respective uses, dosing requirements, potential side effects, and more.
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Understanding Tricyclic Antidepressants (TCAs)
TCAs are a type of antidepressant.
TCAs work on several chemicals in the brain to help with depression (or other off-label uses, such as nerve pain), which include the following:
TCAs are an older group of antidepressants.
Although they are effective, they have more side effects and may take longer to work than some newer types of antidepressants.
How Long Do Antidepressants Take to Work?
Nortriptyline is FDA-approved to treat MDD in adults.
How It Works
Off-Label Uses
Nortriptyline is FDA-approved only for use in adults,
However, some healthcare providers prescribe it off-label, meaning for use or at a dosage for which it has not been FDA-approved, such as in children or teenagers.
Examples of off-label uses of nortriptyline are:
Amitriptyline is FDA-approved for depression in adults and is available as an orally administered tablet.
Historically, amitriptyline was sold under the brand name Elavil, but this brand is no longer available in the United States.
When amitriptyline is converted to nortriptyline in the body, it increases levels of norepinephrine and serotonin in the brain.
While amitriptyline is not FDA-approved for non-adults, some healthcare providers prescribe it off-label in children or teenagers.
Some examples of off-label uses of amitriptyline include:
Amitriptyline in Other Products
While this article focuses on single-ingredient amitriptyline, this active ingredient is also available as an ingredient in several combination drugs, including:
When prescribing these drugs, healthcare providers generally start with a lower dose and gradually increase the dose if necessary, while paying close attention to any side effects.
Nortriptyline Dosing
Nortriptyline capsules are available in the following strengths: 10 milligrams (mg), 25 mg, 50 mg, and 75 mg.
Nortriptyline solution is available as 10 mg/5 milliliter (mL).
Dosing for depression includes the following:
Dosing for nerve pain includes the following:
Amitriptyline Dosing
Amitriptyline tablets are available in the following strengths: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg.
Dosing for nerve pain entails:
Call your healthcare provider immediately if you experience severe side effects that fail to go away or worsen over time.
Furthermore, dial 911 if your symptoms feel life-threatening or if you think you have a medical emergency.
Boxed Warning
For both drugs, the warning states that people who take antidepressants are at risk forsuicidal thoughtsand behaviors. In clinical studies, such suicidal tendencies primarily affected children, teenagers, and young adults.
People of any age who take an antidepressant, however, should be closely monitored for changes in mood or behavior or suicidal thoughts and behaviors.
Help for Depression Is AvailableNo one should suffer from depression. If you are experiencing symptoms of depression, talk to your healthcare provider. If you or someone you know is in a suicidal crisis or emotional distress, you can call or text988for the988 Suicide & Crisis Lifeline.The line is open 24 hours a day, seven days a week in the United States, and provides free, confidential support.Call911or go to the nearest emergency room if you or someone you know is in a life-threatening crisis.
Help for Depression Is Available
No one should suffer from depression. If you are experiencing symptoms of depression, talk to your healthcare provider. If you or someone you know is in a suicidal crisis or emotional distress, you can call or text988for the988 Suicide & Crisis Lifeline.The line is open 24 hours a day, seven days a week in the United States, and provides free, confidential support.Call911or go to the nearest emergency room if you or someone you know is in a life-threatening crisis.
No one should suffer from depression. If you are experiencing symptoms of depression, talk to your healthcare provider. If you or someone you know is in a suicidal crisis or emotional distress, you can call or text988for the988 Suicide & Crisis Lifeline.
The line is open 24 hours a day, seven days a week in the United States, and provides free, confidential support.
Call911or go to the nearest emergency room if you or someone you know is in a life-threatening crisis.
Nortriptyline-Specific Side Effects
Common side effects associated with the use of nortriptyline include:
Severe side effects associated with the use of nortriptyline include:
Amitriptyline-Specific Side Effects
Common side effects associated with the use of amitriptyline include:
Severe side effects associated with the use of amitriptyline include:
Here are some tips for safely taking either nortriptyline or amitriptyline:
Who Should Avoid Nortriptyline or Amitriptyline?
Nortriptyline and amitriptyline are not appropriate for everyone.
Before taking nortriptyline or amitriptyline, notify your healthcare provider of all preexisting medical conditions, your medical history, and your family’s medical history.
You should not take nortriptyline or amitriptyline if you are allergic to either medication, other tricyclic antidepressants, or any inactive ingredients in nortriptyline or amitriptyline.
Other people who should avoid taking nortriptyline or amitriptyline include:
Tell your healthcare provider about all of the medicines you take, including:
While taking nortriptyline or amitriptyline, do not start any new medications without approval from your healthcare provider.
Some drug interactions that apply to both medications include:
This is not a complete list of drug interactions. Other drug interactions may occur with nortriptyline or amitriptyline.
Consult your healthcare provider for more information about drug interactions and how they may affect you.
Summary
Nortriptyline and amitriptyline are orally administered generic TCAs that are FDA-approved to treat MDD or, in an off-label setting, nerve pain or migraine prevention.
In the case of nortriptyline, a brand-name, non-generic form exists, known as Pamelor.
Nortriptyline and amitriptyline are very similar. In fact, amitriptyline metabolizes into nortriptyline after taking it.
Both medications are FDA-approved for depression, and they both have other off-label uses, such as for nerve pain or migraines.
Talk to your healthcare provider for more information and medical advice about these medications.
Frequently Asked QuestionsStore orally administered nortriptyline or amitriptyline at room temperature (68-77 degrees F), away from direct light, heat, and moisture.Do not store either medication in the bathroom or any area susceptible to high levels of heat or moisture.Keep all medications out of the sight and reach of children and pets.TCAs are known for anticholinergic side effects because they block the action of a chemical messenger called acetylcholine.This leads to common side effects such as constipation, dry mouth, blurry vision, difficulty urinating, and confusion.
Store orally administered nortriptyline or amitriptyline at room temperature (68-77 degrees F), away from direct light, heat, and moisture.Do not store either medication in the bathroom or any area susceptible to high levels of heat or moisture.Keep all medications out of the sight and reach of children and pets.
Store orally administered nortriptyline or amitriptyline at room temperature (68-77 degrees F), away from direct light, heat, and moisture.
Do not store either medication in the bathroom or any area susceptible to high levels of heat or moisture.
Keep all medications out of the sight and reach of children and pets.
TCAs are known for anticholinergic side effects because they block the action of a chemical messenger called acetylcholine.This leads to common side effects such as constipation, dry mouth, blurry vision, difficulty urinating, and confusion.
TCAs are known for anticholinergic side effects because they block the action of a chemical messenger called acetylcholine.
This leads to common side effects such as constipation, dry mouth, blurry vision, difficulty urinating, and confusion.
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Nortriptyline.MedlinePlus.Amitriptyline.National Health Service.Side effects - antidepressants.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Nortriptyline.MedlinePlus.Amitriptyline.National Health Service.Side effects - antidepressants.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Nortriptyline.MedlinePlus.Amitriptyline.National Health Service.Side effects - antidepressants.
MedlinePlus.Nortriptyline.
MedlinePlus.Amitriptyline.
National Health Service.Side effects - antidepressants.
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