Key takeaways
Nortriptyline (Pamelor) and trazodone are both used to treat depression, but they belong to different classes of medications. Nortriptyline is a tricyclic antidepressant (TCA) that works by adjusting the levels of serotonin, norepinephrine, and other chemicals in your brain. Trazodone, on the other hand, is an atypical antidepressant and a serotonin antagonist and reuptake inhibitor (SARI), which also affects serotonin levels but in a different way. Nortriptyline is typically taken three or four times a day, while trazodone is usually taken once or a few times a day. Trazodone is sometimes used off-label for insomnia, whereas nortriptyline can be used off-label for chronic pain and nerve pain. Both medications can cause withdrawal symptoms if stopped abruptly, but trazodone is noted for causing extreme sleepiness and dizziness more frequently. Nortriptyline has a higher risk of heart problems, especially in people with a history of heart disease, while trazodone can cause life-threatening abnormal heart rhythms and severe bleeding. Both medications are available in generic forms.
