Until amitriptyline gets metabolized, it circulates throughout the body, potentially causing numerous side effects
. Nortriptyline is not without side effects
, but its side effects are generally milder.
Other drugs that may be considered include Neurontin, Lyrica, Effexor, Lexapro, Cymbalta, and Keppra are worth considering. For my occipital (back of the head) neuralgia, I am getting good relief from Cymbalta, Lyrica, and Keppra.