Masticatory myofascial pain (MFP) is a regional muscle pain distinguished by pain and localized muscle tenderness. The comparative analysis of two Tricyclic antidepressants (TCAs) showed that Nortriptyline (NOR) exhibited better efficacy better tolerated than than Amitriptyline (AMI).

The study directed to define and compare the pharmacotherapeutic efficiencies two tricyclic antidepressants (TCA) medications; Amitriptyline and Nortriptyline for masticatory myofascial pain (MFP) management.

A total of 50 patients selected; 20 were subjected to NOR treatment after discontinuing AMI due to adverse effects, and 30 took AMI only. The comparison of baseline and post-treatment scores were reported by using pain diaries recording verbal pain scores (VPS). Data was analysed by applying t-tests and chi-square.

Both groups exhibited a significantly lower mean ± standard deviation VPS score at the end of treatment and achieved a clinically meaningful (≥ 50%) difference. Both groups exhibited similar primary VPS scores. However, at the study end, lower final VPS along with better 50% improvement rate was shown by NOR group. The patients who achieved a ≥ 50% success rate used the same maximal dosages. 

TCAs are efficient in lessening pain in chronic MFP patients. NOR appears more efficacious and better tolerated than AMI, although further data are required to verify these conclusions due to study limitations.