Comparative Pharmacology
Head-to-head clinical analysis: AMITRIL versus NORTRIPTYLINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMITRIL versus NORTRIPTYLINE HYDROCHLORIDE.
AMITRIL vs NORTRIPTYLINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amitriptyline inhibits the reuptake of serotonin and norepinephrine, thereby increasing their synaptic concentrations. It also blocks histamine H1, alpha-1 adrenergic, and muscarinic receptors.
Nortriptyline is a tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin at the presynaptic neuronal membrane, increasing their concentrations in the synaptic cleft. It also has anticholinergic, antihistaminic, and alpha-adrenergic blocking properties.
Adults: Initial 25 mg PO once daily at bedtime, increase by 25 mg every 3-7 days as tolerated to typical maintenance 75-150 mg/day PO divided doses or single dose at bedtime. Maximum 300 mg/day.
25 mg orally three times daily or 75 mg orally once daily at bedtime; initial dose 25 mg at bedtime, titrate up to 75-150 mg/day.
None Documented
None Documented
Terminal elimination half-life: 15–25 hours (mean 20 h); may extend to >40 h in elderly or hepatic impairment.
Terminal elimination half-life 18-56 hours (mean 28 hours); steady-state reached in 5-7 days.
Renal: ~70% as metabolites, <5% unchanged; fecal: ~30% via bile.
Primarily renal (70% as metabolites, <5% unchanged) and fecal (30% via biliary elimination).
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant