Jump to content
CrazyBoards.org

Recommended Posts

https://en.wikipedia.org/wiki/Amitriptyline

https://en.wikipedia.org/wiki/Nortriptyline

Both are quite similar, and that is no surprise, given that Notrtiptyline is Amitriptyline's major metabolite.

When comparing both, we can ascertain the following: Amitriptyline has somewhat more SERT blocking going on, so might be slightly more "serotonergic" than Nortriptyline, although I am not quite sure if clinically relevant. Both are equally strong NRIs and 5HT2 antagonists. Amitriptyline is a stronger ALPHA1 blocker compared to Nortriptyline, so might cause more postural hypotension. Amitrptyline is a stronger antihistamine than Nortriptyline, so might cause more sedation and appetite. Amitriptyline is a stronger anticholinergic than Nortriptyline, so will probably cause more side effects. (Although stronger sedative and anticholinergic properties might be welcome, depending on the condition)

What I am interested in: Who's been on both and how did they compare? (not only theoretically, but practically)

binding affinities:

nortgpk1f.png

picture source: https://abload.de/img/nortgpk1f.png

 

Edited by Skeletor
Link to comment
Share on other sites

  • 1 month later...

@mikl_pls you've taken at least nortriptyline before, yes? Have you taken both?

@Skeletor nortriptyline does seem to have more NRI effect and less sedative effect than amitriptyline. Nortriptyline is probably more like Fetzima (levomilnacipran) with high NET occupancy at all doses and greater SERT occupancy with higher dosing. Everything I've read about nortriptyline almost describes it as a tricyclic version of bupropion without the dopamine reuptake inhibition. However nortriptyline is a potent 5HT2C antagonist which would disinhibit the release of norepinephrine and dopamine and produce a similar effect. Nortriptyline has potential in the treatment of smoking cessation and ADHD as well.

On the flip-side, amitriptyline has more evidence for sleep-promoting effects. The combination blockade of muscarinic acetylcholine receptors, H1 histamine receptors, and alpha-1 adrenergic receptors at bedtime would be a very sedating pill.

  • Like 1
Link to comment
Share on other sites

@Skeletor, I've tried both, and neither one helped with my depression.....I will say one thing, though..... Amitriptyline had more side effects than nortriptyline, at least for me it did......Amitriptyline made me feel so sedated throughout the day, even though I took it at night, and it also caused significant weight gain for me......Nortriptyline had very little side effects for me, but it did nothing for my depression, as I mentioned.

As I always say, everyone's different......I hope you have success with whatever you choose.

Edited by CrazyRedhead
  • Like 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

  • Similar Content

    • By Skeletor
      It would seem so, at least according to many studies... Gillman regularly mentions that his patients did substantially better on TCAs than on SSRIs (Sertraline might be an exception). Especially Amitriptyline, Clomipramine and Imipramine seem to be superior in effectivity. Is it wise to completely shun those very effective older antidepressants?
    • By Skeletor
      Sertraline standalone makes many people somewhat apathetic, indifferent and unmotivated, and that's why doctor Gillman suggests augmenting it with Nortriptyline OR alternatively taking Clomipramine standalone for the full SNRI effect...
      Did anyone here try both combos? I am getting back on antidepressants and not sure how to proceed... but if I had to choose, I would preferably go for one of the two possibilities.
    • By Skeletor
      As far as I am informed you need stimulants for treatment of ADHD. Most commonly used are Methylphenidate and Atomoxetine. Sometimes stuff like Bupropion is applied. But what about classic antidepressants with stimulant (NRI) properties? Let's say Desipramine or Nortriptyline, Reboxetine!? Can they help to some degree?
    • By Dewey
      Now that I have been on this cocktail for two weeks, I am noticing a new reality.  I want to be more outgoing, I am alot calmer and want to socialize more.
      The downside is that I lack good social skills and the consequences scare me.  I would be laying vulnerable and not knowing how to protect myself. 
      Can I handle the changes with the new me?  The old me, heck, I knew what to expect and how to handle this. 
    • By bigalxyz
      Hello forum,
      I've had long term problems with treatment-resistant depression and also - in the last 3 or 4 years - have suffered from vertigo, migraines and stomach cramps.
      I have been taking 40mg fluoxetine daily which doesn't do much at all - makes me slightly less irritable, give me some very strange & vivid dreams, but not much else.
      Doctor has just given me some nortriptyline to take alongside the fluoxetine as a combination therapy. Initial dose 25mg and then increase to 50mg after 10 days.
      I started with the 25mg of nortriptyline 4 days ago and it has hit me quite hard. I felt very drowsy at first although this has eased a little now. Sleeping a lot too - possibly not a bad thing because my sleep quality isn't great. Feel "stoned" but not necessarily in a good way. On the other hand, no vertigo, no migraines, no stomach cramps and my mood is ok (albeit in a daze).
      I read something about fluoxetine interacting with TCAs like nortriptyline - something to do with liver enzymes that I don't understand - the upshot of it all was that one should be careful with TCA dosages because fluoxetine makes the TCA hang around in the system longer, as if it were a bigger dose than it actually is.
      Doctor has talked about gradually getting the nortriptyline dosage up to 75mg - 100mg in due course. But I don't know on reflection how familiar he is with this drug (especially in combination with fluoxetine) - he is following the guidance of a psychiatrist who assessed me, but I don't think the psychiatrist gave any advice on suitable dosages. Also the doctor said it's ok to drink alcohol in moderation when taking nortriptyline , which contradicts what I've read elsewhere (I don't plan to drink btw).
      I'm a bit concerned...should I be, do you think?
      (I would ask the doctor myself but it can take 3 weeks to get an appointment with him!)
      Thanks,
      A.
       
       
       
       
×
×
  • Create New...