Pamelor vs. Topamax

Head-to-head comparisons of medication uses, side effects, ratings, and more.

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Qudexy Xr

Improves your mood. Pamelor (Nortriptyline) is a good option for treating depression, especially for people who also have problems with persistent nerve pain.Prevents seizures and migraine headaches. Qudexy Xr (Topiramate) is useful for preventing seizures and migraines, and doesn't require blood tests while you're on it.
How it works
Pamelor (Nortriptyline) is a tricyclic antidepressant (TCA). It helps improve your mood by altering the levels of serotonin, norepinephrine, and other similar chemicals in your brain.Qudexy Xr (Topiramate) is an antiepileptic. Researchers don't know exactly how it works, but it seems to affect multiple parts of the brain to control seizures and migraines.
Type of medication
Tricyclic antidepressant (TCA)
Prescription only
AnticonvulsantPrescription only
Available as
  • Pill
  • Liquid
  • Pill
  • Extended release capsule
Used for (click to learn more)
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
Reviews for Qudexy Xr (Topiramate)
-23% vs. Pamelor (Nortriptyline)
-25% vs. Pamelor (Nortriptyline)
-18% vs. Pamelor (Nortriptyline)
Side effects

We haven’t found good data for Pamelor side effects.

FDA side effect reports for Pamelor »
  • Tingling sensation 45%
  • Slowed-down thinking and movements 19%
  • Dizziness 17%
  • Drowsiness 17%
  • Fatigue 17%
  • Change in taste 14%
  • Difficulty with concentration/attention 13%
  • Nervousness 12%
  • Difficulty with memory 11%
  • Vision abnormal 11%
More Topamax side effects »
Risk factors for serious side effects
  • Age 24 years or younger
  • Age 65 years or older
  • Stopping Pamelor (Nortriptyline) suddenly
  • Using other medications that affect serotonin
  • History of heart disease
  • Older age
  • Electrolyte imbalance
Detailed Pamelor (Nortriptyline) risks & warnings »
  • History of depression
    • Children
    • History of metabolic disorders
    • People also taking Depakote
    • Low-carb diet
    • Dehydration
    • Drug interactions
      • Stopping Qudexy Xr (Topiramate) suddenly
      Detailed Qudexy Xr (Topiramate) risks & warnings »
      Pregnancy category
      NFDA pregnancy category (Unknown)

      The FDA hasn’t classified this medicine’s effects on unborn babies. Talk with your doctor about this medicine if you’re pregnant or planning on it.

      See the FDA package insert
      DFDA pregnancy category (Weigh risks vs. benefits)

      Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      See the FDA package insert
      No specific alcohol-related info.No specific alcohol-related info.
      • Take it with food and/or at bedtime to decrease the potential side effects.
      No specific food-related info.
      Kidneys and liver
      No specific kidneys and liver-related info.
      • A few people will get kidney stones.
      • Qudexy Xr (Topiramate) may increase your risk for kidney stones. Stay well-hydrated to lower your risk.
      No specific sex-related info.No specific sex-related info.
      • Stopping Pamelor (Nortriptyline) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3-5 days of stopping the medication, and go away within 1-2 weeks. Work with your doctor to gradually reduce your dose.
      No specific sleep-related info.
      No specific weight-related info.
      • Can cause sleepiness, speech problems, tingling sensations, and weight loss.
      Upsides and benefits
      • Helpful with treating certain types of pain, like migraines or nerve-related pain.
      • Generally well tolerated and has fewer side effects than other medicines in the same class of drugs.
      • Used on its own or with other antiepileptic medicines to lower the frequency of seizures, especially for people with tonic-clonic or partial seizures, or Lennox-Gestaut syndrome.
      • Helpful in preventing frequent migraine headaches.
      • Doesn't need routine blood tests.
      Downsides and risks
      • Side effects are usually manageable, but can be annoying.
      • Increases the risk of falls, especially when used in the elderly.
      • There's an increased chance of it causing heart problems, especially in people with a history of heart problems.
      • Can cause sleepiness, speech problems, tingling sensations, and weight loss.
      • A few people will get kidney stones.
      • Not safe to use if you're pregnant.
      Tips from our pharmacists for people taking the medication
      • Needs to be taken every day for 1 to 2 weeks to start feeling better, and for 6 to 8 weeks to see the full effect of the medication.
      • It's important to keep taking Pamelor (Nortriptyline) even when you feel your symptoms are getting better.
      • Take it with food and/or at bedtime to decrease the potential side effects.
      • Tell your doctor if you notice sudden mood changes or unusual thoughts.
      • If you decide to stop taking Pamelor (Nortriptyline), work with your doctor to slowly get off this medicine to avoid getting withdrawal symptoms.
      • For the first week, avoid activities that require you to be alert.
      • Don't use if pregnant.
      • Can cause tingling skin sensations and reduced appetite.
      • Report any confusion, decreased sweating, fever, or changes in behavior or vision.
      • Takes 3 to 4 weeks to feel full effects on mood.
      Learn more
      More about PamelorSide effectsReviews & ratingsAlternativesFDA package insert
      More about TopamaxSide effectsReviews & ratingsAlternativesFDA package insert