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Nortriptyline is an active metabolite of amitriptyline by demethylation in the liver. Chemically, it is a secondary amine dibenzocycloheptene and pharmacologically it is classed as a first-generation antidepressant. [36] Nortriptyline may also have a sleep-improving effect due to antagonism of the H 1 and 5-HT 2A receptors. [37]
Blood levels of amitriptyline and nortriptyline and pharmacokinetics of amitriptyline in general, with clearance difference of up to 10-fold, vary widely between individuals. [120] Variability of the area under the curve in steady state is also high, which makes a slow upward titration of the dose necessary. [17]
Amitriptyline, sold under the name Elavil, is a tricyclic antidepressant used to treat depression, especially when other medications aren’t effective. It’s also used to treat certain forms of ...
Nortriptyline and desipramine may be preferred medications over other TCAs ... (mean difference: –3.77 points; or with ... of amitriptyline alone [67] [68] or ...
Benzoctamine (Tacitin) – a tetracyclic compound and is closely related to maprotiline, with the two compounds differing only in the length of their side chain, but benzoctamine is not used as an antidepressant and is instead used as an anxiolytic
Serotonin. A serotonin reuptake inhibitor (SRI) is a type of drug which acts as a reuptake inhibitor of the neurotransmitter serotonin (5-hydroxytryptamine, or 5-HT) by blocking the action of the serotonin transporter (SERT).
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If the anti-seizure drugs are found ineffective, one of the tricyclic antidepressant medications, such as amitriptyline or nortriptyline, may be used. The tricyclic antidepressants are known to have dual action against both depression and neuropathic pain.