Sign-in to Ask A Doctor - 24x7
OR
Sign in with GoogleGet your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
Are The Ingredients Of Desipramine Or Nortriptyline Same As Amiptriptyline
my insurance company has jumped my amiptriptyline from a tier 1 to a tier 3, and I cannot afford to buy it. they recommend desipramine or nortriptyline to replace it. are the ingredients the same a amiptriptyline and will they be as effective? it was prescribed by me dr. for insomnia and to prevent migraines-and has been effective for 15 years. will the other 2 drugs recommended have the same effects.
Mon, 6 Apr 2015
Amitriptyline vs Nortriptyline
Both amitriptyline and nortriptyline are tricyclic antidepressants. Nortriptyline, a major metabolite of amitriptyline, is a secondary amine. It is less sedating and better tolerated than amitriptyline. But both have similar side effects, toxicities, and pharmacologic activity.
Amitriptyline and nortriptyline are FDA-approved. Amitriptyline has been better studied and its various off-label uses are better established.
Amitriptyline inhibits serotonin and noradrenaline uptake equally, whereas nortriptyline is a more potent inhibitor of noradrenaline than of serotonin uptake. Nortriptyline has a longer half-life.
Nortriptyline is unique among the antidepressants in that its blood level exhibits the classical therapeutic window effect. Blood concentrations above or below the therapeutic window (60-200 ng/ml) correlate with poor clinical response. Thus, therapeutic monitoring to ensure the drug level within the therapeutic window is critical for successful treatment with nortriptyline.
Nortriptyline provides more rapid antidepressant effect.
Amitriptyline vs Desipramine
Desipramine appears to produce the greater reduction in pain intensity. Clinically meaningful pain relief (moderate or better) is significantly more likely with desipramine than with amitriptyline.
Both amitriptyline and nortriptyline are tricyclic antidepressants. Nortriptyline, a major metabolite of amitriptyline, is a secondary amine. It is less sedating and better tolerated than amitriptyline. But both have similar side effects, toxicities, and pharmacologic activity.
Amitriptyline and nortriptyline are FDA-approved. Amitriptyline has been better studied and its various off-label uses are better established.
Amitriptyline inhibits serotonin and noradrenaline uptake equally, whereas nortriptyline is a more potent inhibitor of noradrenaline than of serotonin uptake. Nortriptyline has a longer half-life.
Nortriptyline is unique among the antidepressants in that its blood level exhibits the classical therapeutic window effect. Blood concentrations above or below the therapeutic window (60-200 ng/ml) correlate with poor clinical response. Thus, therapeutic monitoring to ensure the drug level within the therapeutic window is critical for successful treatment with nortriptyline.
Nortriptyline provides more rapid antidepressant effect.
Amitriptyline vs Desipramine
Desipramine appears to produce the greater reduction in pain intensity. Clinically meaningful pain relief (moderate or better) is significantly more likely with desipramine than with amitriptyline.
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer.
For a more detailed, immediate answer, try our premium service
[Sample answer]
Related questions you may be interested in
Loading Online Doctors....