What Is the Difference between Amitriptyline and Nortriptyline?

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  • Written By: Jay Leone
  • Edited By: M. C. Hughes
  • Last Modified Date: 31 January 2019
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Amitriptyline and nortriptyline are both prescription-strength medications used to treat symptoms associated with depression. Both medications belong to a class of drugs referred to as tricyclic antidepressants. Each increases the production of certain chemicals in the brain that are essential to maintaining mental balance. Aside from the fact that nortriptyline is manufactured in two forms while amitriptyline manufacturers exclusively produce their product in tablet form, there are few differences between these medications.

While amitriptyline is made in tablet form, nortriptyline is available in capsule form and liquid form. Doses of both medications are designed to be taken anywhere between one and four times daily as directed by a doctor. Doctors tend to start patients on lower doses of amitriptyline and nortriptyline before they begin outlining a regimen involving higher doses of these medications. A patient may begin to experience a lessening of the symptoms of depression shortly after taking these medications, and be tempted to discontinue use his or her doctor recommends. Discontinuing use prematurely however, may result in a resurgence of symptoms.

Both of these medications are used in treatment plans for other types of illnesses and conditions. Post-herpetic neuralgia refers to the burning, pains, and aches associated with a former shingles infection. Amitriptyline and nortriptyline can both be used as part of a post-herpetic neuralgia treatment plan. Nortriptyline can also be prescribed to treat panic disorders while amitriptyline is often used to prevent migraines and treat certain eating disorders.


Some patients may experience side effects while taking either of these medications. Common side effects linked with these medications include nausea, weakness or tiredness, dry mouth and blurred vision. Less common but more severe side effects linked with amitriptyline use include severe hives or skin rash outbreaks, rapid or irregular heartbeat, fainting and hallucinating. More severe nortriptyline side effects include high fever, difficulty breathing and yellowing of the eyes or skin. Patients experiencing severe reactions to either of these medications should immediately seek professional medical attention.

Regular amitriptyline and nortriptyline use can be habit-forming. Patients may experience withdrawal symptoms such as headache and nausea after abruptly discontinuing use of these medications. Most doctors will gradually decrease a patient's dose of these medications as part of a post-treatment plan to discourage the development of withdrawal symptoms.


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Post 7

Amitriptyline and nortriptyline are both tricyclic antidepressants that can be used for migraine prevention. My wife took amitriptyline for migraine pain after she fell in 1996. It didn’t work for her, but I know many who have good results with this medication.

A word about starting new medications if I may. One of the frustrating things about starting new medications is that we may not see results right away. It can take up to three long months before we see a reduction in our migraine frequency and severity. During this time potential side effects may lessen as our body adjusts to the new medication.

I hope that helps.

Post 6

I've been on both for migraines and I've found amitriptyline better for me. It does make me drowsy, but nortriptyline gave me horrible nightmares so I woke up tired anyways - plus it didn't supress my headaches as well. To each his own!

Post 5

I have been on both. I've been on Amitriptyline for one year and switched to Notriptyline three months ago. I am not on these meds for depression. I have bilateral ATN.

The side effects with Amitriptyline were fatigue, foggy-head, dry mouth, stomach troubles and constipation. All side effects are less with Nortriptyline. I feel much more like myself.

The doctor switched me from 60mgs Amitrip. to 60mgs Nortrip. I will say I am still adjusting and I went through withdrawal. I have had increased anxiety and irritability. I am slowly getting back to normal.

Post 4

I have used both and prefer nortriptyline. I think it has fewer side effects.

Post 3

I think that nortriptyline is a superior drug to amitriptyline. Nortriptyline is basically the newer version of amitriptyline. Nortriptyline has less side effects and a longer half-life. The good part about a longer half-life is that it makes withdrawal easier.

Post 2

@donasmrs-- I don't think that amitriptyline and notriptyline are too different in terms of side effects. I'm on notriptyline and it gives me headaches, dry mouth and increased appetite. It also made my depression worse in the beginning of treatment and then slowly got better.

I'm not a doctor though, so you need to speak to your doctor about your side effects and the possibility of switching to another medication.

Also, people respond differently to medications. So nortriptyline might give me a lot of side effects and give you very little. It depends on a lot of factors like your dose, your body weight, tolerance and interactions with other medications. So it would be best to ask your doctor and then try nortriptyline for yourself if your doctor approves.

Post 1

Has anyone been on both of these medications? In your experience, which has less side effects and works better for depression?

I'm on amitripyline and it's causing weight gain as a side effect. Since nortripyline is in the same family, I would like to switch to it if it has less side effects. Is this a good idea?

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