Living with depression is draining\u2014especially when your depression symptoms are resistant to treatment. When you have treatment-resistant depression, mental health providers often turn to less common antidepressants to try to relieve symptoms. <\/p>\n\n\n\n
Silenor and Pamelor are two tricyclic antidepressant medications that can be prescribed when first-line depression medications fail to effectively reduce depression symptoms. We\u2019ll be exploring these two tricyclic antidepressants in this article.<\/p>\n\n\n\n
We\u2019ll cover\u2014<\/p>\n\n\n\n
Depression\u2014especially treatment-resistant depression\u2014makes getting treatment feel like it takes an infinite amount of energy. Klarity makes online depression treatment<\/a> easy and hassle-free. When you book on Klarity, you can meet virtually with a board-certified mental health provider who can diagnose and prescribe in 48 hours or less<\/strong>.<\/p>\n\n\n\n How do you get started? It\u2019s easy\u2014schedule an appointment<\/a>, and we\u2019ll connect you with a licensed care provider in your state who can help treat your depression symptoms. <\/p>\n\n\n\n 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 Pamelor and Silenor are both tricyclic antidepressants, which are the oldest antidepressant drug class developed to treat major depressive disorder (MDD). While tricyclics aren\u2019t right for everyone, they can be useful alternatives when other forms of treatment no longer work or aren\u2019t an option. <\/p>\n\n\n\n Tricyclics refer to a class of medications that are used to treat depression, anxiety, and other mental health disorders. They are called tricyclics because their chemical structure contains three rings of atoms.<\/p>\n\n\n\n Tricyclics work by affecting the levels of certain neurotransmitters in the brain, such as serotonin and norepinephrine. These neurotransmitters play a key role in regulating mood, emotions, and other mental processes.<\/p>\n\n\n\n Medications like Silenor and Pamelor block the reuptake of serotonin and norepinephrine by the neurons in the brain, which means that these neurotransmitters stay in the synapse longer and can have a greater effect on mood and other mental processes.<\/p>\n\n\n\n By increasing the levels of these neurotransmitters, tricyclics can help alleviate symptoms of depression, anxiety, and other mental health disorders. <\/p>\n\n\n\n However, tricyclics can also have a range of side effects, including drowsiness, dry mouth, weight gain, and constipation, among others. As such, they are typically only used as a second-line treatment option after other medications have been tried and found to be ineffective.<\/em><\/p>\n\n\n\n While Pamelor and Silenor are both used to treat major depressive disorder, they\u2019re prescribed in different doses and can have unique side effects. Additionally, each antidepressant can be used off-label to treat conditions outside of MDD. <\/p>\n\n\n\n If a medication is used for something other than its FDA-approved use, it’s considered an off-label treatment. If, for example, a medication is FDA-approved to treat cardiovascular conditions but can help alleviate anxiety, healthcare providers may use it to treat anxiety symptoms in an off-label capacity.<\/p>\n\n\n\n Pamelor (Nortriptyline) is primarily prescribed to treat MDD. That said, it can also be used off-label to treat several issues outside of depression. <\/p>\n\n\n\n Silenor is most commonly used to treat depression and anxiety. However, like Pamelor, it also has been prescribed off-label to treat other issues. <\/p>\n\n\n\n Silenor comes in different forms and doses, and how you\u2019ll take it depends on your current symptoms, health history, and the advice of your mental healthcare provider. <\/p>\n\n\n\n Silenor is typically prescribed as a tablet, capsule, or liquid. While everyone\u2019s dosage on this antidepressant varies, you can expect to start with 10 to 75 mg daily. Your healthcare provider may increase that dose to 150 mg daily, depending on your symptoms and how you respond to the initial dosing recommendation. <\/p>\n\n\n\n Doxepin has some possible side effects you should be aware of before taking this antidepressant. <\/p>\n\n\n\n Common side effects include:<\/p>\n\n\n\n Some of these side effects may go away with time, but you should alert your healthcare provider if these possible side effects do not. If you experience any of the following serious side effects while taking this treatment, contact your provider immediately or seek emergency medical care. <\/p>\n\n\n\n Silenor is metabolized by the liver, primarily through the enzyme system known as CYP450. Therefore, a treatment that inhibits or induces this system can affect the metabolism and clearance of Silenor, potentially leading to drug interactions.<\/p>\n\n\n\n Some drugs that may interact with Silenor include:<\/p>\n\n\n\n The price of Silenor varies depending on the dose you\u2019re prescribed and which pharmacy you use. You could pay anywhere from $16.99 to $49.47 a month. If you\u2019re looking for a more affordable alternative, speak with your care provider about using the Silenor.<\/p>\n\n\n\t\t\n\n
\n\t \n<\/th> Pamelor<\/th> Doxepin <\/th>\n<\/tr>\n<\/thead>\n \n\t Drug Class<\/strong><\/td> Tricyclic antidepressant<\/td> Tricyclic antidepressant
\n
\n<\/td>\n<\/tr>\n\n\t Brand \/ Generic Status<\/strong><\/td> Brand name for nortriptyline<\/td> Generic (Brand name: Silenor)
\n
\n<\/td>\n<\/tr>\n\n\t Form(s) of the Drug<\/strong><\/td> \u2022 Immediate-release capsules
\r\n\u2022 Clear, cherry-flavored liquid suspension
\r\n<\/td>\u2022 Immediate-release capsules
\n\u2022 Immediate-release tablets
\n\u2022 Clear, blueberry-mint flavored liquid suspension
\n\u2022 Topical cream (for itching)
\n<\/td>\n<\/tr>\n\n\t Standard Dosage<\/strong><\/td> Immediate-release capsules:
\n\u2022 10mg
\n\u2022 25mg
\n\u2022 50mg
\n\u2022 75mg
\n
\nLiquid suspension:
\n\u2022 10mg per dose
\n
\n<\/td>Immediate-release capsule:
\n\u2022 10mg
\n\u2022 25mg
\n\u2022 50mg
\n\u2022 75mg
\n\u2022 100mg
\n\u2022 150mg
\n
\nImmediate-release tablets:
\n\u2022 3mg
\n\u2022 6mg
\n
\nLiquid suspension:
\n\u2022 10mg per dose
\n
\nTopical cream:
\n\u2022 5% formula
\n<\/td>\n<\/tr>\n\n\t Conditions Treated<\/strong><\/td> FDA-approved uses:
\n\u2022 Major depressive disorder
\n
\nOff-label uses:
\n\u2022 Diabetic neuropathy
\n\u2022 Migraines
\n\u2022 Postherpetic neuralgia or post-shingles skin pain
\n\u2022 Neurogenic cough
\n\u2022 Chronic pain
\n\u2022 Persistent myofascial pain
\n\u2022 Trigeminal neuralgia or painful shock sensations on the face
\n<\/td>FDA-approved uses:
\r\n\u2022 Major depressive disorder
\r\n\u2022 Anxiety disorder
\r\n\u2022 OCD
\r\n
\r\nOff-label uses:
\r\n\u2022 Itchiness due to atopic dermatitis, pruritus, or lichen simplex chronicus
\r\n\u2022 Topical neuropathic pain
\r\n<\/td>\n<\/tr>\n\n\t Cost<\/strong><\/td> Brand name (Pamelor):
\r\n\u2022 $1250 for a 30-day supply (no insurance)
\r\n\u2022 $10 for a 30-day supply (with insurance)
\r\n
\r\nGeneric form (nortriptyline):
\r\n\u2022 $13 for a 30-day supply
\r\n<\/td>Brand name (Silenor):
\n\u2022 $32 to $525 for a 30-day supply
\n
\nGeneric form (doxepin)
\n\u2022 $36 to $90 for a 30-day supply
\n\u2022 $8 for a 30-day supply with coupons\/discounts
\n<\/td>\n<\/tr>\n\n\t Side-Effects<\/strong><\/td> Common side effects:
\n\u2022 Blurred vision
\n\u2022 Impaired coordination
\n\u2022 Physical weakness
\n\u2022 Constipation
\n\u2022 Nausea and vomiting
\n\u2022 Sensitivity to sunlight
\n\u2022 Xerostomia or dry mouth
\n\u2022 Dizziness
\n\u2022 Excessive sweating
\n\u2022 Breast gland tissue growth
\n\u2022 Insomnia
\n\u2022 Drowsiness
\n\u2022 Increased need to urinate
\n\u2022 Abnormal sensations
\n\u2022 Agitation
\n\u2022 Urinary retention
\n\u2022 Tremoring
\n\u2022 Disorientation
\n\u2022 Anxiety
\n\u2022 Changes in blood sugar levels
\n\u2022 Confusion
\n\u2022 Galactorrhea or nipple discharge
\n\u2022 Skin rash
\n\u2022 Itchy skin
\n\u2022 Restlessness
\n<\/td>Common side effects:
\n\u2022 Agitation, confusion
\n\u2022 Black, tarry stools, bleeding gums, blood in urine or stool
\n\u2022 Blurred vision
\n\u2022 A sensation of burning, itching, or \u201cpins and needles\u201d on the skin
\n\u2022 Chest pain or tightness, fast or irregular heartbeat
\n\u2022 Chills, cold sweats
\n\u2022 Urinary retention
\n\u2022 Dizziness upon standing, loss of consciousness
\n\u2022 Headache
\n\u2022 Hearing loss
\n\u2022 Muscle spasms, stiffness, twitching
\n\u2022 Seizures
\n<\/td>\n<\/tr>\n\n\t Warnings For Use<\/strong><\/td> Drug interactions:
\n\u2022 Arbutamine
\n\u2022 Blood thinning medications like Warfarin
\n\u2022 Disulfiram
\n\u2022 Thyroid Supplements
\n\u2022 Anticholinergic drugs
\n\u2022 Clonidine<\/a>
\n\u2022 Guanabenz
\n\u2022 MAOIs
\n<\/td>Drug interactions:
\n\u2022 Thyroid supplements
\n\u2022 Anticholinergic drugs
\n\u2022 Some blood pressure medications: clonidine
\n\u2022 MAO inhibitors: isocarboxazid, linezolid, metaxalone, methylene blue
\n\u2022 SSRIs
\n\u2022 St. John's Wort
\n\u2022 Cimetidine
\n\u2022 Terbinafine
\n\u2022 Drugs to treat irregular heart rate
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\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\nPamelor and Silenor Are the Same Class of Antidepressants (Tricyclics)<\/strong><\/h2>\n\n\n\n
What Are Tricyclics?<\/strong><\/h3>\n\n\n\n
Pamelor and Silenor Are Both Used To Treat Major Depressive Disorder<\/strong><\/h2>\n\n\n\n
What Else Does Pamelor Treat?<\/strong><\/h3>\n\n\n\n
Off-label Uses for Pamelor<\/strong><\/h4>\n\n\n\n
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What Else Does Silenor Treat?<\/strong><\/h3>\n\n\n\n
Off-label Uses for Silenor<\/strong><\/h4>\n\n\n\n
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Doses, Dosage Form, and Side Effects of Silenor<\/strong><\/h2>\n\n\n\n
Common Silenor Doses and Forms<\/strong><\/h3>\n\n\n\n
Common Silenor Side Effects<\/strong><\/h3>\n\n\n\n
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Common Silenor Drug Interactions<\/strong><\/h3>\n\n\n\n
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How Much Does Silenor Cost?<\/strong><\/h3>\n\n\n\n