Key takeaways
Nortriptyline (Pamelor) and paroxetine (Paxil) are both used to treat depression, but they belong to different medication classes. Nortriptyline is a tricyclic antidepressant (TCA) that works by adjusting levels of serotonin, norepinephrine, and other chemicals in your brain, while paroxetine is a selective serotonin reuptake inhibitor (SSRI) that specifically raises serotonin levels. Nortriptyline is also used off-label for chronic pain and nerve pain, whereas paroxetine is approved for a wider range of conditions, including various anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). Nortriptyline is typically taken multiple times a day, while paroxetine is taken once daily. Both medications can cause withdrawal symptoms if stopped abruptly, but paroxetine is more likely to cause weight gain and sexual side effects. Additionally, paroxetine has a higher risk of drug interactions and is not recommended during pregnancy due to potential harm to unborn babies.
