{"id":5288,"date":"2022-11-02T09:08:00","date_gmt":"2022-11-02T16:08:00","guid":{"rendered":"https:\/\/cms.helloklarity.com\/?p=5288"},"modified":"2023-12-20T11:53:15","modified_gmt":"2023-12-20T19:53:15","slug":"pamelor-vs-amitriptyline","status":"publish","type":"post","link":"https:\/\/cms.helloklarity.com\/post\/pamelor-vs-amitriptyline\/","title":{"rendered":"Pamelor vs Amitriptyline"},"content":{"rendered":"\n<p>If you have <strong>treatment-resistant depression<\/strong> and have already spent months trying SSRIs and SNRIs without finding relief from your depression symptoms, you may be ready to throw in the towel.<\/p>\n\n\n\n<p><em>Don\u2019t give up yet<\/em>.&nbsp;<\/p>\n\n\n\n<p>There are antidepressants called tricyclic antidepressants that are usually prescribed after first-line<a href=\"https:\/\/www.klarityadhd.com\/depression\/\" target=\"_blank\" rel=\"noopener\"> depression treatments<\/a> fail.&nbsp;<\/p>\n\n\n\n<p>If you are considering tricyclic antidepressants because other medications haven\u2019t worked for you, two names you\u2019ll want to know are <strong>Pamelor<\/strong> (Nortriptyline HCL) and <strong>Elavil<\/strong> (now only available in the US as generic Amitriptyline).<\/p>\n\n\n\n<p>In this article, Klarity will explore both of these tricyclic medications so that you can decide which, if either, is suitable for you.<\/p>\n\n\n\n<p>We&#8217;ll discuss\u2014<\/p>\n\n\n\n<ul>\n<li>What tricyclic antidepressants are and how they work<\/li>\n\n\n\n<li>Potential side effects, drug interactions, and warnings<\/li>\n\n\n\n<li>How much each antidepressant cost<\/li>\n\n\n\n<li>The forms and doses of each<\/li>\n\n\n\n<li>Plus, we&#8217;ll answer some frequently asked questions the providers on Klarity often get asked<\/li>\n<\/ul>\n\n\n\n<p>Speak to a board-certified mental health professional about your treatment-resistant depression in days\u2014not weeks!<a href=\"https:\/\/care.klarityadhd.com\/assessment\/get-started\" target=\"_blank\" rel=\"noopener\"> Book an appointment on Klarity<\/a>, and you&#8217;ll meet your new provider in <strong>48 hours or less<\/strong>.<\/p>\n\n\n\n<p><em>This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately at 800-273-8255.<\/em><\/p>\n\n\n\n<table id=\"tablepress-35\" class=\"tablepress tablepress-id-35 tablepress-responsive\">\n<thead>\n<tr class=\"row-1 odd\">\n\t<th class=\"column-1\"><\/th><th class=\"column-2\">Pamelor<\/th><th class=\"column-3\">Amitriptyline<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-hover\">\n<tr class=\"row-2 even\">\n\t<td class=\"column-1\"><strong>Drug Class<\/strong><\/td><td class=\"column-2\">Tricyclic antidepressant<\/td><td class=\"column-3\">Tricyclic antidepressant<\/td>\n<\/tr>\n<tr class=\"row-3 odd\">\n\t<td class=\"column-1\"><strong>Brand \/ Generic Status<\/strong><\/td><td class=\"column-2\">Brand name for nortriptyline<\/td><td class=\"column-3\">Generic (Brand name: Elavil)<\/td>\n<\/tr>\n<tr class=\"row-4 even\">\n\t<td class=\"column-1\"><strong>Form(s) of the Drug<\/strong><\/td><td class=\"column-2\">\u2022 Immediate-release capsules<br \/>\n\u2022 Clear, cherry-flavored liquid suspension<br \/>\n<\/td><td class=\"column-3\">\u2022 Tablets<br \/>\n\u2022 Yellow, fruit-flavored liquid suspension<br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-5 odd\">\n\t<td class=\"column-1\"><strong>Standard Dosage<\/strong><\/td><td class=\"column-2\">Capsules: <br \/>\n\u2022 10mg<br \/>\n\u2022 25mg<br \/>\n\u2022 50mg<br \/>\n\u2022 75mg<br \/>\n<br \/>\nLiquid suspension: <br \/>\n\u2022 10mg per dose<br \/>\n<\/td><td class=\"column-3\">Tablets: <br \/>\n\u2022 10mg<br \/>\n\u2022 25mg<br \/>\n\u2022 50mg<br \/>\n\u2022 75mg<br \/>\n\u2022 100mg<br \/>\n\u2022 150mg<br \/>\n<br \/>\nLiquid suspension:<br \/>\n\u2022 10mg per dose<br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-6 even\">\n\t<td class=\"column-1\"><strong>Conditions Treated<\/strong><\/td><td class=\"column-2\">FDA-approved uses:<br \/>\n\u2022 Major depressive disorder<br \/>\n<br \/>\nOff-label uses:<br \/>\n\u2022 Diabetic neuropathy<br \/>\n\u2022 Migraines<br \/>\n\u2022 Postherpetic neuralgia or post-shingles skin pain<br \/>\n\u2022 Neurogenic cough<br \/>\n\u2022 Chronic pain<br \/>\n\u2022 Persistent myofascial pain<br \/>\n\u2022 rigeminal neuralgia or painful shock sensations on the face<br \/>\n<\/td><td class=\"column-3\">FDA-approved uses:<br \/>\n\u2022 Major depressive disorder<br \/>\n\u2022 Anxiety disorder<br \/>\n\u2022 OCD<br \/>\n<br \/>\nOff-label uses: <br \/>\n\u2022 Chronic fibromyalgia pain<br \/>\n\u2022 Nerve pain <br \/>\n\u2022 Sleep disorders <br \/>\n\u2022 Bladder pain <br \/>\n\u2022 Irritable bowel syndrome<br \/>\n<br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-7 odd\">\n\t<td class=\"column-1\"><strong>Cost<\/strong><\/td><td class=\"column-2\">Generic form (nortriptyline): <br \/>\n\u2022 $13 for a 30-day supply<br \/>\n<br \/>\nBrand name: <br \/>\n\u2022 $1250 for a 30-day supply (no insurance)<br \/>\n\u2022 $10 for a 30-day supply (with insurance)<br \/>\n<\/td><td class=\"column-3\">Generic form (amitriptyline):<br \/>\n\u2022 $140 to $300 for a 30-day supply<br \/>\n\u2022 $4 for a 30-day supply with insurance or coupon card<br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-8 even\">\n\t<td class=\"column-1\"><strong>Side-Effects<\/strong><\/td><td class=\"column-2\">Common side effects: <br \/>\n\u2022 Blurred vision<br \/>\n\u2022 Impaired coordination<br \/>\n\u2022 Physical weakness<br \/>\n\u2022 Constipation<br \/>\n\u2022 Nausea and vomiting<br \/>\n\u2022 Sensitivity to sunlight<br \/>\n\u2022 Xerostomia or dry mouth<br \/>\n\u2022 Dizziness<br \/>\n\u2022 Excessive sweating<br \/>\n\u2022 Breast gland tissue growth <br \/>\n\u2022 Insomnia<br \/>\n\u2022 Drowsiness<br \/>\n\u2022 Increased need to urinate<br \/>\n\u2022 Abnormal sensations<br \/>\n\u2022 Agitation<br \/>\n\u2022 Urinary retention<br \/>\n\u2022 Tremoring<br \/>\n\u2022 Disorientation<br \/>\n\u2022 Anxiety<br \/>\n\u2022 Changes in blood sugar levels<br \/>\n\u2022 Confusion<br \/>\n\u2022 Galactorrhea or nipple discharge<br \/>\n\u2022 Skin rash<br \/>\n\u2022 Itchy skin<br \/>\n\u2022 Restlessness<br \/>\n<\/td><td class=\"column-3\">Common side effects:<br \/>\n\u2022 Drowsiness, blurred vision<br \/>\n\u2022 Dry mouth, constipation <br \/>\n\u2022 Weight gain<br \/>\n\u2022 Difficulty urinating <br \/>\n\u2022 Persistent heartburn<br \/>\n\u2022 Easy bruising or bleeding<br \/>\n\u2022 Black stools<br \/>\n\u2022 Vomit that looks like coffee grounds  <br \/>\n\u2022 Muscle spasms, shaking<br \/>\n\u2022 Severe abdominal pain <br \/>\n\u2022 Decreased libido<br \/>\n\u2022 Enlarged or painful breasts <br \/>\n\u2022 Severe dizziness, fainting, seizures, confusion <br \/>\n\u2022 Eye pain, redness or swelling, vision changes <br \/>\n\u2022 Sweating <br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-9 odd\">\n\t<td class=\"column-1\"><strong>Warnings For Use<\/strong><\/td><td class=\"column-2\">Drug interactions: <br \/>\n\u2022 Arbutamine<br \/>\n\u2022 Blood thinning medications like Warfarin<br \/>\n\u2022 Disulfiram<br \/>\n\u2022 Thyroid Supplements<br \/>\n\u2022 Anticholinergic drugs<br \/>\n\u2022 Clonidine<br \/>\n\u2022 Guanabenz<br \/>\n\u2022 MAOIs<br \/>\n<\/td><td class=\"column-3\">Drug interactions:<br \/>\n\u2022 Quinidine<br \/>\n\u2022 Cimetidine <br \/>\n\u2022 Many other antidepressants: SSRIs<br \/>\n\u2022 Type 1C antiarrhythmics <br \/>\n\u2022 MAO inhibitors <br \/>\n\u2022 Thyroid medication <br \/>\n\u2022 Alcohol, barbiturates and other CNS depressants <br \/>\n\u2022 Anticholinergic drugs  <br \/>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-35 from cache -->\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Amitriptyline and Pamelor Are the Same Class of Drugs (Tricyclics)<\/strong><\/h2>\n\n\n\n<p>Medical providers usually turn to tricyclic antidepressants after more modern antidepressants fail to relieve depression symptoms. Like other antidepressants, such as SSRIs and SNRIs, tricyclics elevate the amount of serotonin and norepinephrine available in the brain\u2019s synapses.&nbsp;<\/p>\n\n\n\n<p>Low levels of serotonin and norepinephrine are associated with depression symptoms. Though tricyclics, SSRIs, and SNRIs elevate neurotransmitter levels, the physical mechanism each drug uses to accomplish this is different\u2014<\/p>\n\n\n\n<ul>\n<li>SSRIs and SNRIs are more targeted (selective) and affect serotonin and norepinephrine receptors (dopamine, too) in the brain and central nervous system.&nbsp;<\/li>\n\n\n\n<li>Tricyclics are less targeted (nonselective) and affect receptors all over the brain and body. This means Tricyclics will have more side effects than modern antidepressants because more receptors all over the body are affected.&nbsp;<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What Are Tricyclics?<\/strong><\/h3>\n\n\n\n<p>Tricyclic antidepressants are a class of medications that were among the first developed to treat depression and other mood disorders. They have been in use since the 1950s and are named after their chemical structure, which contains three rings of atoms.<\/p>\n\n\n\n<p>Tricyclic antidepressants work by increasing the levels of certain neurotransmitters, primarily serotonin and norepinephrine, in the brain. These neurotransmitters play a crucial role in regulating mood, and their increased availability is thought to help alleviate depressive symptoms.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Amitriptyline and Pamelor Are Both Used To Treat Major Depressive Disorder<\/strong><\/h2>\n\n\n\n<p>Serotonin and norepinephrine are responsible for various aspects of cognition, emotion, and behavior. Both Pamelor and Amitriptyline prevent the \u201creuptake\u201d of these neurotransmitters so that more are available for your brain to use. But why does your brain need more of these neurotransmitters in circulation?<\/p>\n\n\n\n<ul>\n<li>Low serotonin levels are linked to a higher risk of mood disorders, including depression and anxiety. Additionally, serotonin has a hand in regulating sleep, sexual functions, and wound healing.&nbsp;<\/li>\n\n\n\n<li>Norepinephrine helps regulate emotions, concentration, and memory. It also helps regulate physical systems in the body, such as blood pressure, energy use, and blood sugar levels. Poor concentration, motivation, and energy are symptoms of depression.&nbsp;<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What Makes Amitriptyline and Pamelor Different From One Another?<\/strong><\/h3>\n\n\n\n<p>The chemical structures of Amitriptyline and Pamelor are very similar. Both are compounds called amines\u2014single nitrogen atoms bonded to a lone pair. Amitriptyline is a tertiary amine with three carbon atoms bonded to the nitrogen atom, and Pamelor is a secondary amine with only two carbon atoms attached to the nitrogen atom.<\/p>\n\n\n\n<p>The chemical distinction between the two tricyclics is removed when the body digests Amitriptyline, effectively converting it to Pamelor (Nortriptyline HCL). This is why both medications are so similar\u2014when the body goes to use either, each is effectively the same chemical compound.&nbsp;<\/p>\n\n\n\n<p>When treating depression, the only advantage of taking Pamelor is that it\u2019s already in the final form that affects the targeted neurotransmitters. However, this is a very slight advantage, if at all.<\/p>\n\n\n\n<p>There are greater differences between the two when treating other conditions and illnesses, though even here, there is overlap.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What Else Does Amitriptyline Treat?<\/strong><\/h3>\n\n\n\n<p>There are many off-label uses for Amitriptyline. A medical provider may prescribe it to treat any of the following conditions.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Off-label Uses for Amitriptyline<\/strong><\/h4>\n\n\n\n<ul>\n<li>Anxiety<\/li>\n\n\n\n<li>Irritable bowel syndrome (IBS)<\/li>\n\n\n\n<li>Insomnia<\/li>\n\n\n\n<li>Diabetic neuropathy<\/li>\n\n\n\n<li>Fibromyalgia<\/li>\n\n\n\n<li>Migraines<\/li>\n\n\n\n<li>Postherpetic neuralgia or post-shingles skin pain<\/li>\n\n\n\n<li>Post-traumatic stress disorder (PTSD)<\/li>\n\n\n\n<li>Sialorrhea or excessive saliva flow<\/li>\n\n\n\n<li>Interstitial cystitis or bladder pain syndrome<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What Else Does Pamelor Treat?<\/strong><\/h3>\n\n\n\n<p>Though Pamelor treats many of the same conditions as Amitriptyline, there are a few conditions Pamelor treats that Amitriptyline does not and vice versa.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Off-label Uses for Pamelor that Amitriptyline Also Treats<\/strong><\/h4>\n\n\n\n<ul>\n<li>Diabetic neuropathy<\/li>\n\n\n\n<li>Migraines<\/li>\n\n\n\n<li>Postherpetic neuralgia or post-shingles skin pain<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Off-label Uses for Pamelor that Amitriptyline Doesn\u2019t Treat<\/strong><\/h4>\n\n\n\n<ul>\n<li>Neurogenic cough<\/li>\n\n\n\n<li>Chronic pain<\/li>\n\n\n\n<li>Persistent myofascial pain<\/li>\n\n\n\n<li>Trigeminal neuralgia or painful shock sensations on the face<\/li>\n<\/ul>\n\n\n\t\t<div data-elementor-type=\"page\" data-elementor-id=\"15401\" class=\"elementor elementor-15401\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c521b1f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c521b1f\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1e5f769\" data-id=\"1e5f769\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-8537e6b elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8537e6b\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-f020c0d\" data-id=\"f020c0d\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2478e2a elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"2478e2a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.19.0 - 07-02-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-large\">Licensed providers on Klarity provide personalized treatment. \nFind a provider that matches your needs and preferences.<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-87df69e elementor-widget elementor-widget-spacer\" data-id=\"87df69e\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.19.0 - 07-02-2024 *\/\n.elementor-column .elementor-spacer-inner{height:var(--spacer-size)}.e-con{--container-widget-width:100%}.e-con-inner>.elementor-widget-spacer,.e-con>.elementor-widget-spacer{width:var(--container-widget-width,var(--spacer-size));--align-self:var(--container-widget-align-self,initial);--flex-shrink:0}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container,.e-con>.elementor-widget-spacer>.elementor-widget-container{height:100%;width:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer{height:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner{height:var(--container-widget-height,var(--spacer-size))}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty,.e-con>.elementor-widget-spacer.elementor-widget-empty{position:relative;min-height:22px;min-width:22px}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon,.e-con>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon{position:absolute;top:0;bottom:0;left:0;right:0;margin:auto;padding:0;width:22px;height:22px}<\/style>\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76f1234 elementor-widget-tablet__width-inherit elementor-tablet-align-center elementor-align-center elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"76f1234\" data-element_type=\"widget\" data-settings=\"{&quot;sticky&quot;:&quot;top&quot;,&quot;sticky_on&quot;:[&quot;mobile&quot;],&quot;sticky_offset_mobile&quot;:0,&quot;sticky_effects_offset_mobile&quot;:0,&quot;sticky_offset&quot;:0,&quot;sticky_effects_offset&quot;:0}\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/care.helloklarity.com\/assessment\/get-started?utm_source=blog&#038;utm_medium=cta&#038;utm_campaign=blue\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Find a provider<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Doses, Dosage Form, and Side Effects of Pamelor<\/strong><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Common Pamelor Doses and Forms<\/strong><\/h3>\n\n\n\n<p>Pamelor is available in 10 mg, 25 mg, 50 mg, and 75 mg capsules. Additionally, it is available as a 5 mL oral solution.<\/p>\n\n\n\n<p>For depression, patients often are directed to take 25 mg every six to eight hours and must not exceed 150 mg daily.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Common Pamelor Side Effects<\/strong><\/h3>\n\n\n\n<p>Both Pamelor and Amitriptyline share many side effects because they are chemically very similar. Here is a list of Pamelor\u2019s side effects:<\/p>\n\n\n\n<ul>\n<li>Blurred vision<\/li>\n\n\n\n<li>Impaired coordination<\/li>\n\n\n\n<li>Physical weakness<\/li>\n\n\n\n<li>Constipation<\/li>\n\n\n\n<li>Nausea and vomiting<\/li>\n\n\n\n<li>Sensitivity to sunlight<\/li>\n\n\n\n<li>Xerostomia or dry mouth<\/li>\n\n\n\n<li>Dizziness<\/li>\n\n\n\n<li>Excessive sweating<\/li>\n\n\n\n<li>Breast gland tissue growth&nbsp;<\/li>\n\n\n\n<li>Insomnia<\/li>\n\n\n\n<li>Drowsiness<\/li>\n\n\n\n<li>Increased need to urinate<\/li>\n\n\n\n<li>Abnormal sensations<\/li>\n\n\n\n<li>Agitation<\/li>\n\n\n\n<li>Urinary retention<\/li>\n\n\n\n<li>Tremoring<\/li>\n\n\n\n<li>Disorientation<\/li>\n\n\n\n<li>Anxiety<\/li>\n\n\n\n<li>Changes in blood sugar levels<\/li>\n\n\n\n<li>Confusion<\/li>\n\n\n\n<li>Galactorrhea or nipple discharge<\/li>\n\n\n\n<li>Skin rash<\/li>\n\n\n\n<li>Itchy skin<\/li>\n\n\n\n<li>Restlessness<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Common Pamelor Drug Interactions<\/strong><\/h3>\n\n\n\n<p>This list of drug interactions is not exhaustive. Always share all medications, supplements, and dietary restrictions with your doctor before starting medication.<\/p>\n\n\n\n<p>Avoid the following while taking Pamelor:<\/p>\n\n\n\n<ul>\n<li>Arbutamine<\/li>\n\n\n\n<li>Blood-thinning medications like Warfarin<\/li>\n\n\n\n<li>Disulfiram<\/li>\n\n\n\n<li>Thyroid Supplements<\/li>\n\n\n\n<li>Anticholinergic drugs<\/li>\n\n\n\n<li><a href=\"https:\/\/www.klarityadhd.com\/post\/clonidine-for-anxiety\/\" data-type=\"link\" data-id=\"https:\/\/www.klarityadhd.com\/post\/clonidine-for-anxiety\/\" target=\"_blank\" rel=\"noopener\">Clonidine<\/a><\/li>\n\n\n\n<li>Guanabenz<\/li>\n<\/ul>\n\n\n\n<p>Avoid taking MAO Inhibitors, which can cause a potentially fatal drug interaction. MAO inhibitors should be avoided two weeks before and after taking Pamelor.<\/p>\n\n\n\n<p>Common MAO inhibitors include:<\/p>\n\n\n\n<ul>\n<li>Isocarboxazid<\/li>\n\n\n\n<li>Linezolid<\/li>\n\n\n\n<li>Metaxalone<\/li>\n\n\n\n<li>Methylene Blue<\/li>\n\n\n\n<li>Moclobemide<\/li>\n\n\n\n<li>Phenelzine<\/li>\n\n\n\n<li>Procarbazine<\/li>\n\n\n\n<li>Rasagiline<\/li>\n\n\n\n<li>Safinamide<\/li>\n\n\n\n<li>Selegiline<\/li>\n\n\n\n<li>Tranylcypromine&nbsp;<\/li>\n<\/ul>\n\n\n\n<p>Patients must be cautious when taking other medications that elevate serotonin levels to avoid developing serotonin syndrome.<\/p>\n\n\n\n<p>Additionally, patients should monitor drugs that cause drowsiness when taking Pamelor, such as opioids, other painkillers, or allergy medications that induce drowsiness.<\/p>\n\n\n\n<p>Here is an<a href=\"https:\/\/reference.medscape.com\/drug\/pamelor-nortriptyline-342944#3\" target=\"_blank\" rel=\"noopener\"> exhaustive list of drug interactions<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>How Much Does Pamelor Cost?<\/strong><\/h3>\n\n\n\n<p>Pamelor costs about $1250 for a 30-day supply of 10 mg capsules. Though with insurance, the price can be below $10 for a monthly supply. Generic Pamelor (Nortriptyline HCL) costs around $13 without insurance.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Doses, Dosage Form, and Side Effects of Amitriptyline<\/strong><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Common Amitriptyline Doses and Forms<\/strong><\/h3>\n\n\n\n<p>Amitriptyline is available in tablet form at 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg.<\/p>\n\n\n\n<p>To treat depression, medical providers often start patients with 25 &#8211; 50 mg\/day tablets and increase the dose every 5 &#8211; 7 days up to 100 &#8211; 200 mg\/day. Doctors recommend the medication be taken once a day at bedtime.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Common Amitriptyline Side Effects<\/strong><\/h3>\n\n\n\n<p>Though Amitriptyline is very similar to Pamelor, Amitriptyline has a few side effects that Pamelor doesn\u2019t have. Here is a list of Amitriptyline\u2019s most common side effects:<\/p>\n\n\n\n<ul>\n<li>Nausea<\/li>\n\n\n\n<li>Headaches<\/li>\n\n\n\n<li>Vomiting<\/li>\n\n\n\n<li>Dry mouth<\/li>\n\n\n\n<li>Drowsiness<\/li>\n\n\n\n<li>Physical weakness<\/li>\n\n\n\n<li>Confusion<\/li>\n\n\n\n<li>Nightmares<\/li>\n\n\n\n<li>Unsteadiness<\/li>\n\n\n\n<li>Excessive sweating<\/li>\n\n\n\n<li>Confusion<\/li>\n\n\n\n<li>Blurred vision<\/li>\n\n\n\n<li>Changes in weight<\/li>\n\n\n\n<li>Changes in appetite&nbsp;<\/li>\n\n\n\n<li>Constipation<\/li>\n\n\n\n<li>Urinary retention&nbsp;<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Common Amitriptyline Drug Interactions<\/strong><\/h3>\n\n\n\n<p>Being chemically comparable to Pamelor, many of the drug warnings for Amitriptyline will be similar.<\/p>\n\n\n\n<p>Patients should avoid medications that thin the blood, MAO inhibitors, other serotonin-elevating drugs, and medications that induce drowsiness.<\/p>\n\n\n\n<p>Common medications that thin the blood include<\/p>\n\n\n\n<ul>\n<li>Heparin<\/li>\n\n\n\n<li>Warfarin<\/li>\n\n\n\n<li>Aspirin<\/li>\n\n\n\n<li>Clopidogrel<\/li>\n<\/ul>\n\n\n\n<p>Common MAO inhibitors include<\/p>\n\n\n\n<ul>\n<li>Marplan (Isocarboxazid)<\/li>\n\n\n\n<li>Nardil (Phenelzine)<\/li>\n\n\n\n<li>Emsam (Selegiline)<\/li>\n\n\n\n<li>Parnate (Tranylcypromine)<\/li>\n<\/ul>\n\n\n\n<p>Here is an exhaustive<a href=\"https:\/\/reference.medscape.com\/drug\/levate-amitriptyline-342936#3\" target=\"_blank\" rel=\"noopener\"> list of drug interactions<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>How Much Does Amitriptyline Cost?<\/strong><\/h3>\n\n\n\n<p>Amitriptyline costs about $13 for a 28-day supply without insurance as a generic drug. With insurance, the price can be below $5.&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Do I Need A Prescription for Amitriptyline or Pamelor?<\/strong><\/h2>\n\n\n\n<p>Yes, to take both Amitriptyline and Pamelor, a patient needs a prescription from a qualified medical provider. These medications are prescribed after modern antidepressants\u2014like SNRIs and SSRIs\u2014fail to relieve depression symptoms.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Other Tricyclic Side Effects<\/strong><\/h2>\n\n\n\n<p>Patients must be aware of other side effects that tricyclic medications (and other medications that affect a person\u2019s neurotransmitter levels) can have on the mind and body.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Black Box Warning<\/strong><\/h3>\n\n\n\n<p>All antidepressants come with a <strong>black box warning<\/strong>. In short-term studies, antidepressants, including amitriptyline and Pamelor, caused an increase in suicidal thoughts in children, teens, and young adults.<\/p>\n\n\n\n<p>Mental health professionals and the children\u2019s parents need to weigh the benefits of antidepressants against the risks and monitor for adverse changes in behavior and suicidal thoughts. This risk was not observed in patients between the ages of 25 and 65.&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What is Serotonin Syndrome?<\/strong><\/h3>\n\n\n\n<p>When too much serotonin builds up in the brain due to medication, it can lead to a drug reaction called serotonin syndrome, which can be fatal. Mild serotonin syndrome can cause shivering and diarrhea, while severe serotonin syndrome can cause muscle rigidity, seizures, and fever.&nbsp;<\/p>\n\n\n\n<p>Serotonin syndrome most often occurs when starting a new drug or increasing the dose of a current drug. Patients need to monitor for serotonin syndrome symptoms, usually within a few hours of taking a new drug or drug dose.&nbsp;<\/p>\n\n\n\n<p>Symptoms of serotonin syndrome include<\/p>\n\n\n\n<ul>\n<li>Agitation<\/li>\n\n\n\n<li>Insomnia<\/li>\n\n\n\n<li>Restlessness<\/li>\n\n\n\n<li>Confusion<\/li>\n\n\n\n<li>Rapid heart rate<\/li>\n\n\n\n<li>Dilated pupils<\/li>\n\n\n\n<li>Loss of muscle control<\/li>\n\n\n\n<li>Seizures<\/li>\n\n\n\n<li>High blood pressure<\/li>\n\n\n\n<li>Shivering<\/li>\n\n\n\n<li>Diarrhea<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Pregnancy and Breastfeeding on Tricyclics<\/strong><\/h3>\n\n\n\n<p>It is generally considered safe for mothers taking nortriptyline to breastfeed with no risk to the child. Though nortriptyline does pass through breast milk, the amount is minimal. A few studies<a href=\"https:\/\/mothertobaby.org\/fact-sheets\/nortriptyline-fs\/#:~:text=Nortriptyline%20passes%20into%20breast%20milk,all%20of%20your%20breastfeeding%20questions.\" target=\"_blank\" rel=\"noopener\"> reported no side effects from nortriptyline exposure<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Increased Bleeding Risk With Tricyclics<\/strong><\/h3>\n\n\n\n<p>When taken in combination with blood thinners, tricyclics can increase the risk of bleeding by exacerbating the effects of the blood thinners. However,<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3212440\/#:~:text=Tricyclic%20antidepressants%20(TCAs)%20are%20also,agents%20may%20increase%20bleeding%20risk.\" target=\"_blank\" rel=\"noopener\"> no evidence suggests tricyclics increase bleeding risk when used alone<\/a>.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Pamelor and Amitriptyline Frequently Asked Questions<\/strong><\/h2>\n\n\n\n<p>We\u2019ve compiled common questions we receive from patients below:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What is Pamelor?<\/strong><\/h3>\n\n\n\n<p>Pamelor (nortriptyline) is a tricyclic antidepressant medication that helps treat depression symptoms and other conditions off-label.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What is Amitriptyline?<\/strong><\/h3>\n\n\n\n<p>Amitriptyline is another tricyclic antidepressant medication used to treat depression and other conditions.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Are Pamelor, Amitriptyline, and other Tricyclics the same drug?<\/strong><\/h3>\n\n\n\n<p>Tricyclics as a drug category are relatively diverse. However, Pamelor and Amitriptyline are nearly identical chemically. When the body digests Amitriptyline, it converts into nortriptyline (Pamelor). Though there are slight differences, they are effectively the same drug.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Why is Pamelor an off-label treatment for anxiety?<\/strong><\/h3>\n\n\n\n<p>Serotonin and norepinephrine are vital neurotransmitters that help regulate thoughts, mood, and behavior. Medications such as Pamelor that elevate serotonin and norepinephrine can help regulate mood disorders like anxiety, reducing anxiety symptoms.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What\u2019s better for anxiety? Pamelor or Amitriptyline?<\/strong><\/h3>\n\n\n\n<p>Both Pamelor and Amitriptyline can help relieve anxiety symptoms. However, they aren\u2019t more effective than other medications explicitly used to address anxiety. Because both drugs are similar, one doesn\u2019t have the edge over the other.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What\u2019s better for depression? Pamelor or Amitriptyline?<\/strong><\/h3>\n\n\n\n<p>Both Pamelor and Amitriptyline are clinically proven to be effective at treating symptoms of depression. These two medications are nearly identical and have very similar side effects. In general, one isn\u2019t remarkably better at treating depression than the other. However, you might tolerate one medication better than the other.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can I drive on antidepressants like Pamelor or Amitriptyline?<\/strong><\/h3>\n\n\n\n<p>Both medications can cause drowsiness. Before operating heavy machinery, driving, or doing other attention-oriented tasks, it&#8217;s essential to fully understand how the medication impacts you.<\/p>\n\n\n\n<p>However, you can drive on Pamelor or Amitriptyline if you do not experience drowsiness as a side effect or if that side effect goes away after a few weeks.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can I drink alcohol on Pamelor or Amitriptyline?<\/strong><\/h3>\n\n\n\n<p>It is not recommended that people taking tricyclics consume alcohol. Drinking alcohol while on tricyclics can make the medication\u2019s side effects worse.&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Does it matter what time of day I take Pamelor or Amitriptyline?<\/strong><\/h3>\n\n\n\n<p>Due to potential drowsiness as a side effect, most mental health professionals recommend taking these medications at night before bed.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Klarity Can Connect You With A Depression Specialist In Under 48 Hours<\/strong><\/h2>\n\n\n\n<p>Do you have treatment-resistant depression but can&#8217;t afford to wait weeks to see an in-person provider and get the treatment you need? Klarity makes finding online depression treatment easy.<\/p>\n\n\n\n<p><a href=\"https:\/\/care.klarityadhd.com\/assessment\/get-started\" target=\"_blank\" rel=\"noopener\">Book an appointment on Klarity<\/a>, and we\u2019ll connect you with a medical provider in under <strong>48 hours<\/strong>.<\/p>\n\n\n\n<p><em>No more lengthy waiting periods and weeks in between follow-ups. You get the care you need fast.<\/em><\/p>\n\n\n\n<p>Sources<\/p>\n\n\n\n<p>\u201cBlood Thinners.\u201d <em>MedlinePlus<\/em>. <a href=\"https:\/\/medlineplus.gov\/bloodthinners.html\" target=\"_blank\" rel=\"noopener\">https:\/\/medlineplus.gov\/bloodthinners.html<\/a><\/p>\n\n\n\n<p>Cait O\u2019Sullivan, PharmD; Courtenay, BC; Cristi Froyman, RPh; Kelowna, BC. \u201cNortriptyline safer than amitriptyline?\u201d <em>National Library of Medicine<\/em>. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6135127\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6135127\/<\/a><\/p>\n\n\n\n<p>\u201cCompare Elavil vs. Pamelor.\u201d <em>Iodine<\/em>. <a href=\"https:\/\/www.iodine.com\/compare\/elavil-vs-pamelor\" target=\"_blank\" rel=\"noopener\">https:\/\/www.iodine.com\/compare\/elavil-vs-pamelor<\/a><\/p>\n\n\n\n<p>Editorial Staff at Hims. \u201cNortriptyline vs Amitriptyline: What&#8217;s The Difference?\u201d <em>Hims<\/em>. <a href=\"https:\/\/www.forhims.com\/blog\/nortriptyline-vs-amitriptyline\" target=\"_blank\" rel=\"noopener\">https:\/\/www.forhims.com\/blog\/nortriptyline-vs-amitriptyline<\/a><\/p>\n\n\n\n<p>Mayo Clinic Staff. \u201cMonoamine oxidase inhibitors (MAOIs).\u201d <em>Mayo Clinic<\/em>. <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/maois\/art-20043992\" target=\"_blank\" rel=\"noopener\">https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/maois\/art-20043992<\/a><\/p>\n\n\n\n<p>Annamarya Scaccia. \u201cEverything You Need to Know About Serotonin.\u201d <em>Healthline<\/em>.&nbsp; <a href=\"https:\/\/www.healthline.com\/health\/mental-health\/serotonin#functions\" target=\"_blank\" rel=\"noopener\">https:\/\/www.healthline.com\/health\/mental-health\/serotonin#functions<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>If you have treatment-resistant depression and have already spent months trying SSRIs and SNRIs without finding relief from your depression symptoms, you may be ready to throw in the towel. Don\u2019t give up yet.&nbsp; There are antidepressants called tricyclic antidepressants that are usually prescribed after first-line depression treatments fail.&nbsp; If you are considering tricyclic antidepressants [&hellip;]<\/p>\n","protected":false},"author":29,"featured_media":5289,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[75],"temp_settings":[116],"_links":{"self":[{"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/posts\/5288"}],"collection":[{"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/comments?post=5288"}],"version-history":[{"count":10,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/posts\/5288\/revisions"}],"predecessor-version":[{"id":17203,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/posts\/5288\/revisions\/17203"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/media\/5289"}],"wp:attachment":[{"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/media?parent=5288"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/categories?post=5288"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/tags?post=5288"},{"taxonomy":"temp_settings","embeddable":true,"href":"https:\/\/cms.helloklarity.com\/wp-json\/wp\/v2\/temp_settings?post=5288"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}