Doctor insights on:
Amitriptyline Vs Nortriptyline
If you are not getting the desired response on a low dose of Nortriptyline 20mg, could you switch to Amitriptyline as a straight swap?
Yes: But why would you want to. Amitriptyline may not provide you the same relief. ...Read more
Classified as a tricyclic antidepressant, and considered of modest benefit these days due to significant anti-cholinergic side effects (drowsiness, dizziness, dryness of mouth, blurring, and perhaps effect on bladder). Confusion may occur in older folks. Had some value in migraine prevention at one point. Used rarely these days as ...Read more
What is the difference between amitriptyline and nortriptyline? Is one more potent for certain things. Read that nortrip helps tinnitus for instance
Amitrip or Nortrip: Both drugs are in the same class called tricyclic antidepressants and have similar pharmacologic activity. Amitriptyline is converted by the body to nortriptyline. Amitriptyline tends to cause more sedation and nortriptyline is used when a more stimulatory side effect is desired. Amitriptyline is preferred when nightime drowsiness is desirable. Both drugs, in high doses can cause cardiac toxicity ...Read more
As a migraine sufferer. I have tried propranolol, amitriptyline, nortriptyline, toprimate and currently on sanomigrain. What would you suggest next.
Migraine treatment: Once a diagnosis of migraine has been made, effective management of migraine involves three specific strategies: 1) patient education, 2) nonpharmacological management (e.g. acupuncture), and 3) pharmacological (medical) management. See an orofacial pain or headache specialist for evaluation and professional management. ...Read more
In your option which migraine preventatives do you feel most effective. I've tried amitriptyline and nortriptyline but hallucinations were bad at nigt?
Which tcas is more potent for sciatica pain relief, amitriptyline (or nortriptyline), imipramine (or desipramine)?
TCA: Tca are classic for neuropathic pain - sciatica for example. Any of the ones u mentioned may be quite eefective - and cheap. They are not without side effects - dry mouth, constipation, sedation. Any of the ones u mentioned can be effective. I personally like amytryptilline - 10mg at night - as mentioned all will work. Additionally other meds such as lyrica, (pregabalin) neurontin, Cymbalta are options. ...Read more
I've asked a lot: Of MD's this question. Some start you off on the new med right after stopping the old one. Some wait as much as two weeks. You are mixing an herb with a Tricyclic, so I'd play it safe and wait awhile. As a psychiatrist who knows about herbs. Most don't. ...Read more
Nortriptylene: Generally a doctor would prescribe an antidepressant like nortriptylene to help someone's life, not ruin it. Depression itself can ruin a life! But this medicine can also bring side effects like rapid heart rate, dry mouth, constipation, and sexual problems. If you're having symptoms you think may be related to this medicine, it's time to discuss it with your doctor. Other options are available. ...Read more
Older antidepressant: Classified as a tricyclic antidepressant, and considered of modest benefit these days due to significant anti-cholinergic side effects (drowsiness, dizziness, dryness of mouth, blurring, and perhaps effect on bladder). Confusion may occur in older folks. Had some value in migraine prevention at one point. Used rarely these days as better meds are available. ...Read more
Side effects persist:
Established blood level measuring and therapeutic ranges are available to guide dosing and provide feedback if doses threaten safety for example cardiac.
Most abandon meds that provide significant side effects. They can be unpleasant but can cause various medical problems in their own right. Weight gain, dry eyes/mouth, urinary hesitancy, sedation, memory problems. All are reversible. ...Read more
Talk w/psychiatrist: Before making this decision, please discuss it with the doctor who prescribed it for you (hopefully a psychiatrist). Together you need to review the initial problems you were having, and see where you are with them now. Otherwise these could return when the nortriptylene is tapered or stopped. ...Read more
Worth a try: Complex regional pain syndrome is a challenging problem to treat, and your doctors will be trying a number of options to help you. Amitriptylene at low dose may have some positive effects in pain syndromes. If you're not already working with a pain medicine specialist on this problem, you might consider a consultation. ...Read more