What is nortriptyline?
Nortriptyline is a second-generation tricyclic antidepressant. You can buy Nortriptyline brands, such as Sensoval, Aventyl, Pamelor, Norpress, Allegron, Noritren and Nortrilen. It is used to treat the major depressive disorder and nocturnal enuresis (bedwetting) in children. Furthermore, the drug is sometimes used to treat chronic diseases, such as chronic fatigue syndrome, chronic pain and migraine, and liability in some neurological diseases.
It provides the minimal sedation effect. The drug is efficient to cope with hypochondriacal states. The antidepressant effect of the drug occurs rapidly in the first two weeks of intake.
What is nortriptyline used for?
Nortriptyline is used to treat:
- All forms of endogenous depression (neurotic and reactive);
- Depressive state in manic-depressive psychosis;
- Involutional depression;
- Depressive-apathetic syndromes developed on the background of cerebral arteriosclerosis;
- In combination with amitriptyline to treat depression, which was a result of treatment with reserpine;
- In conjunction with antipsychotics to treat depressions, which were the result of schizophrenic psychosis treatment.
The drug is also used to help people quit smoking.
Nortriptyline and neuropathic pain
Although the drug is not approved by FDA to treat neuropathic pain, a large number of randomized controlled trials have demonstrated the effectiveness of tricyclic antidepressants to treat this disease in those suffering from depression as well as other people. According to recent research sponsored by the The International Association for the Study of Pain (IASP), Nortriptyline is recommended as a first-line drug for treatment of neuropathic pain.
Avoid taking Nortriptyline in you have a myocardial infarction. It is also not recommended to use the drug if you suffer from depression with suicide attempts. In addition, the drug can not be taken simultaneously with antidepressants with stimulating effect.
Your doctor should adjust your dosage individually, focusing on your body reaction to the drug. Elderly people should take a reduced amount of Nortriptyline. Typically, the drug is taken 3-4 times a day, with the daily average dosage of 75-100 mg. In some cases, the dosage may be increased up to 150 mg of Nortriptyline a day. It is not recommended to exceed this dosage. Once you get positive results of treatment, it makes sense to reduce your dosage to minimal maintenance dosage.
Nortriptyline side effects
Nortriptyline may cause side effects. Tell your doctor if you experience any of the following symptoms:
- weakness or fatigue
- excitement or anxiety
- dry mouth
- changes in appetite or weight
- frequent urination
- blurred vision
- change in sex drive or ability
- excessive sweating
Some side effects can be serious. If you experience any of the following symptoms contact your doctor immediately or get emergency medical help:
- jaw, neck, and back muscle spasms
- slow or difficult speech
- shuffling walk
- uncontrollable shaking of a body part
- difficulty breathing or swallowing
- yellowing of the skin or eyes
- irregular heartbeat
Nortriptyline can cause other side effects not listed above.
However, according to statistics side effects of Nortriptyline are rarer than from the first generation tricyclic antidepressants (e.g., Imipramine (Tofranil), amitriptyline (Elavil)). That is why the drug is often used to treat elderly patients. A study of men showed that taking Nortriptyline is associated with an increased risk of suicidal thoughts, compared with taking Escitalopram.
Special instructions. Nortriptyline potentiates the effect of other anticholinergic drugs, reduces hypotensive effect of reserpine, guanethidine, clonidine, enhances alcohol action. Barbiturates and other antiepileptic drugs, causing induction of microsomal enzymes, increase Nortriptyline metabolism. Neuroleptics, cimetidine, methylphenidate, oral contraceptives reduce Nortriptyline metabolism.
The symptoms and treatment of an overdose are basically the same as the in case of all tricyclic antidepressants. Overdose symptoms include serotonin syndrome and side effects associated with the cardiovascular system.
If you think you took too much of Nortriptyline and experience some unpleasant side effects, call the ambulance immediately or contact your doctor.