Originally Posted by rose of his heart

Both amitriptyline HCI and nortriptyline HCI are tricyclic antidepressants often prescribed for people with chronic pain and co-occurring or resultant sleeping difficulties. They are NOT the same drug but in the same family. Amitriptyline (marketed as Elavil) is a first generation tricyclic anti-d; nortriptyline is a second-generation anti-d with (for some people) fewer side-effects. I have gleaned from reading that taking either of these with MAOIs may be a really bad idea. Maybe Rick can help us understand why (I still struggle to understand neuropharmacology and then to remember what i learned.)

In any case, I tried amitriptyline a few years ago (2+ years prior to PD dx) for my then-unexplained depression, anxiety and chronic pain. I have to say that it did help with each of those as well as with sleeping. Unfortunately I also felt apathetic and spaced out...which decreased my effectiveness in my job. I don't think I took the drug for very long for that reason; perhaps that SE would have gone away (?). My doc tells me that I can take it as needed/occasionally on top of my fluoxetine (an SSRI) as amitripyline is immediately available to the body but I am not yet convinced that is a great idea. My psychiatrist is a very bright, educated, wonderful doctor but I am beginning to wonder whether I should consult with someone even more knowledgeable and/or experienced with treating Parkinson's. Any thoughts on this?