Two medicines, side by side
Nortriptyline vs bupropion
Nortriptyline and bupropion are both labeled for depression. Drugs@FDA records approvals of nortriptyline since 1964 and of bupropion since 1985. Pharmacies paid $0.113 per nortriptyline HCl 10 mg capsule and $0.0785 per bupropion HCl xl 150 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, nortriptyline is a tricyclic antidepressant and bupropion an aminoketone.
Check it at the source: the nortriptyline FDA label on DailyMed (effective December 4, 2024); the bupropion FDA label on DailyMed (effective June 21, 2024).
Highlights of the nortriptyline record
Nortriptyline (Pamelor) · label of December 4, 2024
Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of nortriptyline hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
Used for
From the label: indicationsPamelor™ (nortriptyline HCl) is indicated for the relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other depressive states.
On the market
- Earliest approval on file
- November 6, 1964
- Generic labelers
- 25 labelers
- Pharmacy cost
- $0.113 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Highlights of the bupropion record
Bupropion (Wellbutrin) · label of June 21, 2024
SUICIDAL THOUGHTS AND BEHAVIORS SUICIDALITY AND ANTIDEPRESSANT DRUGS Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. These trials did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in subjects over age 24; there was a reduction in risk with antidepressant use in subjects aged 65 and older [see Warnings and Precautions (5.1)].
Used for
From the label: indicationsBupropion hydrochloride extended-release tablets (SR) are indicated for the treatment of major depressive disorder (MDD), as defined by the Diagnostic and Statistical Manual (DSM). The efficacy of bupropion in the treatment of a major depressive episode was established in two 4-week controlled inpatient trials and one 6-week controlled outpatient trial of adult subjects with MDD [see Clinical Studies (14)]. […]
On the market
- Earliest approval on file
- December 30, 1985
- Generic labelers
- 69 labelers
- Pharmacy cost
- $0.0785 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 35
Source: FDA drug labels via openFDA (Nortriptyline label of December 4, 2024, Bupropion label of June 21, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do nortriptyline and bupropion differ on the record?
In FDA's classes, nortriptyline is a tricyclic antidepressant and bupropion an aminoketone.
Both labels carry a boxed warning; the records quote them.
Generics: nortriptyline since 1992; bupropion since 1999 (Drugs@FDA).
| Nortriptyline | Bupropion | |
|---|---|---|
| Labeled for | Depression | Depression, Quitting smoking |
| Pharmacologic class | Tricyclic Antidepressant | Aminoketone |
| How it works (label) | n/a | The exact mechanism of the antidepressant action of bupropion is not known, but is presumed to be related to noradrenergic and/or dopaminergic mechanisms. |
| Half-life (label) | n/a | The mean elimination half-life (±SD) of bupropion after chronic dosing is 21 (±9) hours, and steady-state plasma concentrations of bupropion are reached within 8 days. |
| Earliest approval on file (Drugs@FDA) | November 6, 1964 | December 30, 1985 |
| First generic approved | March 30, 1992 | November 29, 1999 |
| Generic labelers (NDC) | 25 labelers | 69 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.113 per capsule (Nortriptyline HCl 10 mg capsule) | $0.0785 per tablet (Bupropion HCl xl 150 mg tablet) |
| 12-month price change | -2% | -21% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 35 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 5,761 | 140,269 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Nortriptyline label, warningsIf concomitant use of Pamelor with other serotonergic drugs, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, and St. John’s Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases.
Source: FDA drug labels via openFDA
What next?
- Alternatives to nortriptyline
- every medicine labeled for the same conditions