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Amitriptyline may not be the right choice for every patient. In such cases, it is important to discuss with a medical provider potential amitriptyline alternatives.

Amitriptyline Alternatives

What are your options when it comes to alternatives for amitriptyline? If you are unable to take amitriptyline or if it is not working effectively, your medical provider might recommend an alternative medication for treating the symptoms of depression.

Some of the alternatives that might be recommended include nortriptyline, desipramine, imipramine, or doxepin. These medications are used to help improve mood and manage symptoms of depression. Research shows that nortriptyline and desipramine are associated with side effects that are more tolerable than the side effects of other antidepressants, including amitriptyline.

In some cases, fluoxetine might be used for depression as an alternative to amitriptyline. Research indicates that fluoxetine might be more effective at treating major depression with associated anxiety, for example.

There are many other antidepressants that can be used for anxiety and other conditions.

For Migraines

Those who are unable to use amitriptyline for migraines have other options available. Other tricyclic antidepressants are sometimes used for migraines, including protriptyline and doxepin. Another alternative is nortriptyline, which works in a similar way as amitriptyline for managing migraines. However, nortriptyline generally produces fewer side effects compared to amitriptyline.

For Sleep

Amitriptyline is sometimes prescribed as a way to treat insomnia or other sleep problems. Individuals who need an alternative to this medication for sleep issues have other options available.

Other tricyclic antidepressants, such as doxepin, are sometimes used for insomnia due to their sedating effects. A 2013 study showed that low doses of doxepin were effective at treating insomnia without becoming habit-forming. Other types of antidepressants are also used for insomnia in some individuals, such as mirtazapine, trazodone, or nefazodone.

For Nerve Pain

For more information, please visit our page on amitriptyline for nerve pain.

For Pain

Amitriptyline is sometimes used to treat pain caused by different health problems, such as arthritis, facial pain, and back pain. When this medication cannot be used, other tricyclic antidepressants might be prescribed for managing pain. Some of these medications include nortriptyline, doxepin, desipramine, clomipramine, protriptyline, or imipramine. Out of these medications, nortriptyline, imipramine, and desipramine have been associated with fewer side effects compared to clomipramine and doxepin.

Other medications like gabapentin / pregabalin and other pain medications can also be used for pain.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.


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