Nortriptyline
Uses of Nortriptyline
Nortriptyline is primarily used for managing Major Depressive Disorder (MDD) and belongs to the class of tricyclic antidepressants.
Besides this main use, Nortriptyline is also prescribed for managing neuropathic pain, which is chronic pain resulting from nerve damage such as diabetic neuropathy and postherpetic neuralgia. It may also be used for managing nocturnal enuresis (bedwetting) in children aged 6 years and older.
Side effects of Nortriptyline
Dry mouth
Blurred vision
Drowsiness
Dizziness
Constipation
How Nortriptyline works
Nortriptyline is a tricyclic antidepressant.
It operates by hindering the reuptake of two neurotransmitters, namely norepinephrine and serotonin, at nerve endings. This action increases their concentration in the brain and thus enhances neurotransmission, which helps control mood and reduce pain signals. Nortriptyline also has anticholinergic properties, which can cause side effects like dry mouth and constipation.
Certified content
Written By
Doctor of Medicine
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Nortriptyline can be taken orally (capsules and solution).
Age and Dose Restrictions
This medication is prescribed for adults and children above the age of 6 years.
Contraindications
This medicine is contraindicated in patients with hypersensitivity to Nortriptyline or any other tricyclic antidepressants. It is also contraindicated in patients with recent myocardial infarction, heart block, severe cardiovascular disorders, and those undergoing concurrent MAO inhibitor therapy.
Other Medications to Avoid
Nortriptyline may interact with MAO inhibitors (such as selegiline, isocarboxazid), SSRIs (such as escitalopram, fluoxetine), SNRIs (such as venlafaxine, duloxetine), CYP2D6 inhibitors (like fluoxetine, quinidine) and sympathomimetics (like phenylephrine, epinephrine).
Overdose and Missed Dose
An overdose of Nortriptyline can cause symptoms like irregular heartbeat, severe drowsiness and seizures. Immediate medical attention should be sought in such cases.
If you miss a dose of this medicine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Management of Side Effects
Most side effects are temporary and generally harmless and resolve when discontinuing this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
Drinking plenty of water can help manage dry mouth caused by this medication.
If you experience constipation, increase your fibre intake by consuming fruits, vegetables and whole grains.
Use in Driving and Operating Machinery
Nortriptyline may cause drowsiness or dizziness. Avoid driving or operating heavy machinery if you experience these side effects.
Use in Pregnancy and Lactation
Nortriptyline should only be used during pregnancy and lactation if the benefits outweigh the potential risks. It is advised to consult your doctor before using this medicine during pregnancy and lactation.
Caution in Other Conditions
Patients with a history of seizures, cardiovascular disease, glaucoma, or liver disease should exercise caution when taking Nortriptyline.
Special Dietary and Lifestyle Recommendations
Mind-body practices like yoga, meditation, and deep breathing exercises can help manage stress and improve mood.
It's advisable to maintain a regular sleep schedule to manage symptoms of depression effectively.
Frequently asked questions
Is Nortriptyline a type of painkiller?
No, Nortriptyline is not a painkiller. It is an antidepressant medication which can also help to manage neuropathic pain.
Can Nortriptyline cause weight gain?
Yes, weight gain may occur as a side effect of taking Nortriptyline.
Does Nortriptyline affect blood pressure?
Nortriptyline can potentially cause changes in blood pressure. It may trigger orthostatic hypotension, which is a sudden decrease in blood pressure when standing up from sitting or lying down.
Is it safe to consume alcohol while taking Nortriptyline?
It is generally not recommended to consume alcohol while taking Nortriptyline as it may enhance the side effects of the medicine such as drowsiness and dizziness.
How long does Nortriptyline stay in your system?
Nortriptyline has an elimination half-life ranging from 18-56 hours. This means that it takes about 18 to 56 hours for half of the medicine to be eliminated from your system.
What happens if I stop taking Nortriptyline suddenly?
Stopping Nortriptyline suddenly may lead to withdrawal symptoms. Therefore, this medicine should be tapered gradually under the guidance of a doctor.
How long does Nortriptyline take to work?
Nortriptyline could take a few weeks before you notice an improvement in your symptoms. Its full effect may not be seen until after 4 weeks or longer.
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