amitriptyline vs nortriptyline

PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.

Side-by-side comparison of amitriptyline and nortriptyline. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
amitriptyline Tricyclic Antidepressant (TCA)
nortriptyline Tricyclic Antidepressant (TCA)
Type
amitriptyline Prescription
nortriptyline Prescription
Summary
amitriptyline

Amitriptyline is a medicine used to treat depression. It may take up to 30 days to feel the full effect.

nortriptyline

Nortriptyline (Pamelor) is a medicine used to treat depression. It can help improve your mood.

What It Treats
amitriptyline

Amitriptyline is used to relieve the symptoms of depression. It works best for a type of depression called endogenous depression. This is depression that comes from within, rather than being caused by outside events.

nortriptyline

Nortriptyline is used to relieve the symptoms of depression. It may work better for some types of depression than others. Talk to your doctor to see if nortriptyline is right for you.

How It Works
amitriptyline

Amitriptyline belongs to a class of drugs called tricyclic antidepressants (TCAs). It works by increasing the levels of certain chemicals in your brain. These chemicals help improve your mood.

nortriptyline

Nortriptyline is a tricyclic antidepressant (TCA). It works by increasing the levels of certain natural chemicals in the brain. These chemicals help regulate mood.

Common Side Effects
amitriptyline
  • Drowsiness
  • Dizziness
  • Weakness
  • Fatigue
  • Headache
nortriptyline
  • Dry mouth
  • Blurred vision
  • Constipation
  • Drowsiness
  • Dizziness
FAERS Reports
amitriptyline
  • Pain 1,565
  • Nausea 1,434
  • Headache 1,381
  • Fatigue 1,371
  • Dyspnoea 1,340
nortriptyline
  • Pain 695
  • Headache 679
  • Fatigue 593
  • Nausea 513
  • Hyperhidrosis 485
Serious Warnings
amitriptyline

Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Your doctor should closely monitor you for worsening depression or unusual changes in behavior. Amitriptyline is not approved for use in children.

nortriptyline

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. Your doctor will monitor you closely for worsening depression or unusual changes in behavior. Families and caregivers should also watch for these changes.

Pregnancy
amitriptyline

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if amitriptyline will harm your unborn baby. Amitriptyline can pass into breast milk.

nortriptyline

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Nortriptyline may not be safe for your baby. Talk to your doctor about the risks and benefits.

Also Compare, Nearby Drugs

How to Read This amitriptyline vs nortriptyline Comparison

amitriptyline is classified in the Tricyclic Antidepressant (TCA) drug class, while nortriptyline sits within the Tricyclic Antidepressant (TCA) class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, amitriptyline has 7,091 submissions while nortriptyline has 2,965. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for amitriptyline or nortriptyline.

Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.