Two medicines, side by side
Nortriptyline vs sertraline
Nortriptyline and sertraline are both labeled for depression. Drugs@FDA records approvals of nortriptyline since 1964 and of sertraline since 1991. Pharmacies paid $0.113 per nortriptyline HCl 10 mg capsule and $0.0507 per sertraline HCl 100 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 sertraline a serotonin reuptake inhibitor.
Check it at the source: the nortriptyline FDA label on DailyMed (effective December 4, 2024); the sertraline FDA label on DailyMed (effective August 8, 2023).
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 sertraline record
Sertraline (Zoloft) · label of August 8, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [See Warnings and Precautions (5.1) ]. WARNING: SUICIDAL THOUGHTS AND BEHAVIORS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsZOLOFT is indicated for the treatment of the following [See Clinical Studies (14) ]: • Major depressive disorder (MDD) • Obsessive-compulsive disorder (OCD) • Panic disorder (PD) • Posttraumatic stress disorder (PTSD) • Social anxiety disorder (SAD) • Premenstrual dysphoric disorder (PMDD) ZOLOFT is a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of ( 1 ): • Major depressive disorder […]
On the market
- Earliest approval on file
- December 30, 1991
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0507 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Source: FDA drug labels via openFDA (Nortriptyline label of December 4, 2024, Sertraline label of August 8, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do nortriptyline and sertraline differ on the record?
In FDA's classes, nortriptyline is a tricyclic antidepressant and sertraline a serotonin reuptake inhibitor.
Both labels carry a boxed warning; the records quote them.
Generics: nortriptyline since 1992; sertraline since 2006 (Drugs@FDA).
| Nortriptyline | Sertraline | |
|---|---|---|
| Labeled for | Depression | Depression, Anxiety |
| Pharmacologic class | Tricyclic Antidepressant | Serotonin Reuptake Inhibitor |
| How it works (label) | n/a | Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT). |
| Half-life (label) | n/a | The average terminal elimination half-life of plasma sertraline is about 26 hours. |
| Earliest approval on file (Drugs@FDA) | November 6, 1964 | December 30, 1991 |
| First generic approved | March 30, 1992 | June 30, 2006 |
| Generic labelers (NDC) | 25 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.113 per capsule (Nortriptyline HCl 10 mg capsule) | $0.0507 per tablet (Sertraline HCl 100 mg tablet) |
| 12-month price change | -2% | -3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 3 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 5,761 | 218,311 |
| 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)
Do their labels mention each other?
Nortriptyline label, drug interactionsWhile all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
Source: FDA drug labels via openFDA
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.
Sertraline label, warnings and precautionsIncreased risk when co-administered with other serotonergic agents, but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to nortriptyline
- every medicine labeled for the same conditions