Difference Between Elavil And Pamerol
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Any neurochemists out there? I'm curious about the difference between Elavil (Amitriptyline) and Pamerol (Nortriptyline). Both are tricyclic antidepressants and I've been told that Amitriptyline metabolizes into Nortriptyline plus some other stuff and that "other stuff" is what was making me so groggy.
Answer:
my understanding is that there is an active agent in the tricyclics as well as metabolites that are active on different neurotransmitters, or inactive. so for example imipramine is metabolized into desipramine at almost a 50% rate. Now some of the stuff that isn't metabolized doesn't effect mood or side effects at all...but some of it does. The dry mouth, sleepiness etc don't all come from the active metabolite, so sometimes you can take something that is in fact a metabolite (pamelor, desipramine) and cut off some of the side effects. Still they don't knwo how the stuff works so they might loose some effect they wanted (such as falling asleep easier) if they give you a different drug. My feeling is that they try and choose which one would match best with the problem and have the least side effects if the pamelor doesn't work there are still other tryciclics that are less sedating...i believe that imipramine is less sedating than amytriptyline and desipramine is supposed to be...
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