What is the difference between nortriptyline and amitriptyline

The utility of tricyclic antidepressants in disease management and the prevalence of treatment-limiting side effects can both be predicted by receptor potency. Anticholinergic side effects are strongly associated with tricyclic antidepressants and elicited by strong antagonism at the muscarinic receptor. As these medications are dosed once daily, this side effect may prove beneficial in patients with sleeping disorders. However, a hangover effect has been reported and should be evaluated on a case-to-case basis.

It is also important to note the potential for orthostatic hypotension, which is induced by antagonism at the alpha 1 adrenergic receptor. Just like potency at all other receptors, it varies between members of the tricyclic antidepressant class. As a class, tricyclic antidepressants are unique and often challenging to use, and their side effect profile will continue to limit their clinical utility in many patients.

This article was reviewed and edited by Timothy J. January 25, Place for Tricyclic Antidepressants in Neuropathic Pain Treatment Despite their established efficacy, tricyclic antidepressants have moved out of favor because of their limiting side effect profile, which includes dry mouth, sedation, and blurred vision. Tricyclic Antidepressant Receptor Selectivity and Affinity It should be noted that the utility of tricyclic antidepressants and their associated negative side effects are not equally shared across this drug class.

Peripheral neuropathy: differential diagnosis and management. Am Fam Physician. Neuropathic pain in adults: pharmacological management in non-specialist settings. Published November Accessed January 20, Institute of Medicine. Veterans and Agent Orange: update Background: Amitriptyline is a tricyclic antidepressant that acts primarily as a serotonin-norepinephrine reuptake inhibitor, with strong actions on the serotonin transporter, and moderate effects on the norepinephrine transporter.

Blood concentrations of amitriptyline may be used by clinicians to monitor concentrations during therapy. Nortriptyline will not change your personality or give you a high of feeling happy. It will simply help you feel like yourself again. Do not expect to feel better overnight though. Some people feel worse during the first few weeks of treatment before they begin to feel better. When nortriptyline is taken for nerve pain, most people are able to sleep better within a few days and the pain starts to wear off after a week or so.

If your pain does not get better or you have side effects, talk to your doctor as there may be other treatments which work for you. Talk to your doctor if you take nortriptyline for depression and you do not feel better after taking it for 6 weeks, or the side effects bother you.

If you take nortriptyline for pain, once your pain is under control, you'll probably continue to take it for as long as it's working for you. Some people take it for many months and even for years. If you take nortriptyline for depression, it's likely you'll take it for several more months once you're feeling better. Most doctors recommend that you take antidepressants for 6 months to a year after you've stopped feeling depressed.

Stopping before then can make depression come back. Talk to your doctor about the risks and benefits of continuing to take nortriptyline for more than a few months. There do not seem to be any lasting harmful effects from taking nortriptyline for many months or years.

Nortriptyline is not addictive but you can get withdrawal side effects if you stop taking it suddenly. You may have flu-like symptoms like feeling sick, muscle pain and feeling tired or restless. To help prevent this happening, your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking nortriptyline for a long time.

You may get withdrawal side effects when you stop taking nortriptyline, especially if you stop taking it suddenly. These side effects are a physical reaction as the medicine leaves your body. They can include sweating, being sick, feeling anxious, and difficulty falling asleep. To help prevent them, your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking nortriptyline for a long time.

Do not stop taking nortriptyline suddenly, or without talking to your doctor. Paracetamol and ibuprofen are safe to take with nortriptyline for a short time. Talk to your doctor if you need to take them for more than a few days.

A few people have sex-related problems while they take nortriptyline. Both men and women may have changes in their sex drive. Sexual side effects are not very common and should pass after the first couple of weeks.

If they do not, and this is a problem for you, go back to your doctor to see if there's another medicine you can try. Nortriptyline is usually prescribed by your doctor if other painkillers, such as paracetamol and ibuprofen, have not worked.

Nortriptyline does not work any better or worse than other medicines for nerve pain. Nortriptyline does not work any better or worse than other antidepressants. However, sometimes people respond better to one antidepressant than another.

The best antidepressant for you depends on your symptoms and what medicines have worked for you in the past. Talk to your doctor if you are not feeling any better after taking nortriptyline for 6 weeks or if the side effects still bother you. Nortriptyline can change how hungry you feel. Some people feel more hungry when they're taking it, and others feel less hungry. So your weight may change when you first start taking it. If you start to have problems with your weight while taking nortriptyline, talk to your doctor or pharmacist.

You can drink alcohol while taking nortriptyline but it may make you feel sleepy. It might be best to stop drinking alcohol until you see how the medicine makes you feel. Apart from being extra careful with alcohol, you can eat and drink normally while taking nortriptyline. Nortriptyline does not affect any type of contraception including the combined pill and emergency contraception. There's no clear evidence to suggest that nortriptyline affects fertility in either men or women.

However, speak to your doctor or a pharmacist before taking nortriptyline if you're trying to get pregnant. Some people feel sleepy while they're taking nortriptyline. It's best to stop driving, cycling or operating machinery for the first few days and after each dose increase, until you know how this medicine makes you feel.

See smartphone apps to check your skin. DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Tricyclic antidepressants — codes and concepts open. Treatment or procedure. Amitriptyline, Nortriptyline, Sympathetically maintained pain, Neuropathic pain, Neuropathic itch, Antihistamine, Amitriptyline dose, Adverse effects of tricyclics.

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