Nortriptyline

Description

Nortriptyline is a tricyclic antidepressant primarily used to treat depression and sometimes for pain management in conditions such as neuropathic pain. It works by affecting neurotransmitters in the brain, helping to elevate mood and alleviate feelings of sadness or anxiety.

Uses / Indications

• Major depressive disorder
• Fibromyalgia
• Chronic pain conditions (e.g., neuropathic pain)
• Migraine prevention
• Anxiety disorders
• Sleep disorders related to depression

Dosage and Administration

Adults:
Initial dose of 25 mg taken orally, 1 to 3 times daily. The dose may be gradually increased as directed by a healthcare provider.

Elderly or sensitive patients:
Starting dose may be lower (e.g., 10 mg) to assess tolerance.

Note: Dosage may vary based on medical condition or doctor’s advice.

How It Works (Mechanism of Action)

Nortriptyline works by inhibiting the reuptake of two key neurotransmitters: norepinephrine and serotonin. By increasing the levels of these neurotransmitters in the brain, it enhances mood and alleviates depression symptoms. Additionally, it may block certain pain pathways, offering relief for chronic pain conditions.

Side Effects

Common side effects:

• Dry mouth
• Drowsiness
• Constipation
• Weight gain

Rare/serious side effects:

• Fast or irregular heartbeat
• Severe allergic reactions (rash, swelling, difficulty breathing)
• Suicidal thoughts or behavior (especially in younger individuals)

Seek medical attention if serious side effects occur.

Precautions / Warnings

• Inform your doctor if you have a history of heart disease, seizures, or glaucoma
• Use caution if combining with other medications that cause drowsiness
• May cause withdrawal symptoms if stopped abruptly; consult your doctor for a discontinuation plan

Drug Interactions

May interact with:

• MAO inhibitors (could lead to serious side effects)
• Benzodiazepines and other sedatives
• Certain antihistamines
• Medications affecting liver enzymes

Always inform your healthcare provider about any other medications or supplements you’re taking.

Storage Instructions

• Store at room temperature (20°C–25°C / 68°F–77°F)
• Keep away from moisture, heat, and direct light
• Keep out of reach of children

Missed Dose / Overdose

Missed a dose?
Take it as soon as you remember. If it’s nearly time for your next dose, skip the missed one. Do not double up.

Overdose symptoms:

• Severe drowsiness
• Fast or irregular heartbeat
• Confusion or agitation
• Seizures

Contact a poison control center or seek emergency medical help immediately.

Contraindications

• Allergic to Nortriptyline or other tricyclic antidepressants
• Use of MAO inhibitors within the last 14 days

Brand Names / Alternatives

• Pamelor
• Aventyl
• Nortriptyline Hydrochloride (generic)
• Various generics available