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)
picture source: https://abload.de/img/nortgpk1f.png
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.
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?
So I was manic for 8 weeks. I am now severely depressed and my pdoc took me of fluoxetine when i was manic, but now she has put me back on fluoxetine 20 mg. I'm worried I will become manic again. I had a very bad manic episode this time and don't want a reccurance.
If you became manic on an antidepressant how long did it take for you to become manic. Was it gradual or sudden? I wonder could I recognize symptoms quickly and go off it.
I am currently cross tapering from Paroxetine (Paxil) to Fluoxetine (Prozac) for OCD. Right now I am taking 20mg Fluoxetine and 30mg Paroxetine. The idea is to stop Paroxetine and to increase dose of Fluoxetine to 40 or 60mg.
Could you share with me, in your opinion, what is the optimal dose to treat OCD symptoms?