Hm, I've been on both amitriptyline and nortriptyline.
Nortriptyline may also have a sleep-improving effect due to its affinity for 5HT2A and histaminergic receptors In the short term; however, nortriptyline may disturb sleep due to its activating effect. However, even at the start amitriptyline was great for sleep, but nether did anything for my tinnitus sadly.
But there are studies which say otherwise-
"Nortriptyline (Aventyl®) is tricyclic antidepressant that is also used to treat chronic fatigue, migraine and chronic pain (
193–
196). Its primary mode of action is to inhibit the reuptake of norepinephrine and, to a lesser extent, 5-HT. Nortriptyline also blocks muscarinic and 5-HT receptors. In a small, single-blind, placebo-washout study involving patients with severe tinnitus and major depression, nortriptyline significantly reduced depression and tinnitus loudness (10-dB reduction) (
197). In a double-blind, placebo-controlled, follow-up study involving subjects with severe tinnitus and severe depression or depressive symptoms, nortriptyline significantly reduced depression scores, tinnitus disability scores and tinnitus loudness (6.4-dB reduction) relative to placebo (
198). There was a significant correlation between the reduction in tinnitus disability scores and depression scores (
199). These results suggest that nortriptyline is effective in reducing tinnitus loudness and severity in severely depressed tinnitus patients, but has less benefit in nondepressed individuals.
Intervention: Nortriptyline (maintained at 50 to 150 mg/mL for 6 weeks) or placebo.
"Efficacy of amitriptyline in the treatment of subjective tinnitus.
Bayar N1,
Böke B,
Turan E,
Belgin E.
Author information
Abstract
We investigated the effect of amitriptyline, a tricyclic antidepressant, on patients with subjective tinnitus. The study group consisted of 37 adult patients admitted to the Ear, Nose, and Throat and Audiology Department of Hacettepe University. The amitriptyline group consisted of 20 patients and the placebo group consisted of 17 patients. All of the patients were evaluated using a questionnaire, audiologic evaluation, high-frequency audiometry, impedancemetric tests, auditory brainstem response, tinnitus frequency, and loudness matching assessed by audiometric methods at the beginning and end of the study. The patients in the amitriptyline group received 50 mg/day amitriptyline in the first week and 100 mg/day for the following 5 weeks. In the placebo group, the patients received tablets consisting of lactose starch for 6 weeks, with a dosage of 1 tablet/day. The subjective complaints of the patients in the amitriptyline group decreased, and the "present" symptoms resulted in fewer complaints. The severity of tinnitus decreased in the amitriptyline group by means of subjective and audiometric methods. In the placebo group, no significant change was observed.
The success of treatment was 95% in the amitriptyline group and 12% in the placebo group. Amitriptyline therapy was concluded to be effective."