Nortriptyline
About
Nortriptyline belongs to a group of medicines called 'tricyclic antidepressants' primarily used to treat depression. Additionally, it is also used to treat neuropathic pain and bedwetting at night. Depression is a mental illness or disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.
Nortriptyline contains Nortriptyline that works by affecting certain chemical messengers (serotonin, norepinephrine) in the brain which communicate between brain cells, thereby regulating mood and preventing depression. Besides this, Nortriptyline also the transmission of pain signals, thereby provides relief from neuropathic pain.
Take Nortriptyline as prescribed by your doctor. You are advised to take Nortriptyline for as long as your doctor has prescribed it for you depending on your medical condition and response to the treatment. In some cases, you may experience certain common side-effects such as increased heart rate, flushing, drowsiness, weight gain, difficulty in urination, orthostatic hypotension (sudden lowering of blood pressure on standing), dryness in the mouth, tingling in the arms or legs, blurred vision (dilated pupils). Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.
To treat your condition effectually, continue taking Nortriptyline for as long as your doctor has prescribed. Inform your doctor if you have suicidal ideation or behavior symptoms, heart disease, seizure disorders, glaucoma, thyroid problems, kidney and liver problems. Do not take Nortriptyline if you are pregnant or breastfeeding unless prescribed by the doctor. The safety and effectiveness in children less than 18 years of age have not been established, so Nortriptyline should not be given to them. Avoid consuming alcohol along with Nortriptyline as it could lead to increased drowsiness and dizziness. Consult your doctor immediately if you have suicidal thoughts such as killing or harming yourself. Rise slowly from sitting or lying position as Nortriptyline causes orthostatic hypotension (sudden lowering in blood pressure leading to dizziness on standing). Keep your doctor informed about your health condition and medicines to rule out any side effects.
Uses of Nortriptyline
Medicinal Benefits
Nortriptyline belongs to a group of medicines called tricyclic antidepressants used to prevent depression. It works by affecting certain chemical messengers (serotonin and/or norepinephrine) in the brain which communicate between brain cells, thereby helps in regulating mood and treats depression. Nortriptyline prevents the transmission of pain signals, thereby provides relief from neuropathic pain.
Directions for Use
Storage
Side Effects of Nortriptyline
- Increased heart rate
- Flushing
- Drowsiness
- Weight gain
- Difficulty in urination
- Constipation
- Orthostatic hypotension (sudden lowering of blood pressure on standing)
- Dryness in the mouth
- Tingling in the arms or legs
- Blurred vision
In-Depth Precautions and Warning
Drug Warnings
Do not take Nortriptyline if you are known to be allergic to Nortriptyline. Inform your doctor if you have suicidal ideation or behaviour symptoms, have heart rhythm problems or hypotension, heart disease, seizure disorders, bone marrow suppression, diabetes, schizophrenia, bipolar disorder, acute alcohol intoxication, glaucoma, thyroid problems, kidney and liver problems. Do not take Nortriptyline if you are pregnant or breastfeeding unless prescribed by the doctor. Nortriptyline should not be given to the children less than 18 years of age, as its safety and efficacy have not been established. Avoid consuming alcohol along with Nortriptyline as it could lead to increased drowsiness and dizziness. Rise slowly from sitting or lying position as Nortriptyline causes orthostatic hypotension (sudden lowering in blood pressure leading to dizziness on standing).
Drug Interactions
Drug-Drug Interaction: Nortriptyline may have interaction with monoamine oxidase inhibitors (medicines used to treat depression) (moclobemide, phenelzine, iproniazid, isocarboxazid, nialamide, tranylcypromine, selegiline) medicine to treat high blood pressure (diltiazem, verapamil, guanethidine, debrisoquine, bethanidine, clonidine, reserpine, methyldopa ) pain killers (tramadol, trazodone, hydrocodone, oxycodone, acetaminophen), antidepressant (bupropion, duloxetine, fluoxetine, sertraline), antihistamine (diphenhydramine, cetirizine), sedatives (zolpidem), muscle relaxant (cyclobenzaprine), medicines to treat fungal infections (fluconazole, terbinafine, ketoconazole, and itraconazole), anti-thyroid (levothyroxine).
Drug-Food Interaction: Avoid St. John´s Wort (a herbal remedy used for depression) and alcohol as it may increase the risk of side effects when taken along with Nortriptyline.
Drug-Disease Interaction: If you have suicidal ideation or behavior, have disease conditions such as heart disease, seizure disorders, bone marrow suppression, diabetes, schizophrenia, bipolar disorder, acute alcohol intoxication, glaucoma, thyroid problems, kidney and liver problems.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid consumption of alcohol while taking Nortriptyline as it may cause an increased sedative effect. Please consult a doctor before consuming alcohol with Nortriptyline.
Pregnancy
unsafeAvoid taking Nortriptyline if you are pregnant unless prescribed by a doctor. Please consult your doctor if you have any concerns regarding this, your doctor will prescribe only if the benefits outweigh the risks.
Breast Feeding
cautionConsult your doctor before taking Nortriptyline; your doctor will decide whether Nortriptyline can be taken by breastfeeding mothers or not.
Driving
cautionNortriptyline may affect your ability to drive or operate machinery safely. Therefore, drive only if you are alert after taking Nortriptyline.
Liver
cautionTake Nortriptyline with caution, especially if you have a history of liver disease/conditions. The dose may be adjusted by your doctor as required.
Kidney
cautionDose adjustment may be needed in patients with kidney impairment. Please consult your doctor if you have kidney impairment or any concerns regarding this.
Children
unsafeNortriptyline is not recommended for children below the age of 18. The safety and efficacy of Nortriptyline have not been established.
Habit Forming
Diet & Lifestyle Advise
- Maintain a healthy diet and exercise regularly helps in improving overall health and boosts self-esteem.
- Regularly attend therapy sessions.
- Perform meditation and yoga. This helps in relieving stress and provides relaxation.
- Follow a regular sleep pattern to improve the amount and quality of sleep you get.
- Include foods rich in omega fatty acids such as fish, nuts, fresh fruits, vegetables and olive oils.
- Neurotransmitters are made up of amino acids. Amino acid-rich foods such as meat, dairy products and certain fruits and vegetables help in the proper maintenance of neurotransmitters.
- Complex carbohydrates help in stimulating serotonin (a feel-good neurotransmitter). These include whole grains, legumes, spinach, broccoli, oranges and pears.
- Exercising helps in the production of the body’s natural antidepressants. It also helps in relieving stress, improving mood, boosts self-esteem and provides restful sleep.
- Avoid smoking and alcohol consumption.
- Learn about your condition, understand the risk factors and follow the doctor’s treatment plan.
Special Advise
- Nortriptyline may increase the risk of suicidal thoughts and behavior for people younger than 24 years. If you have symptoms of suicidal ideation or behavior, please consult your doctor before taking Nortriptyline.
- Do not use Nortriptyline if you have used an MAO inhibitor in the past 14 days, as a dangerous drug interaction could occur.
- Nortriptyline may increase your risk of seizures. If you have a history of seizures, your doctor will monitor you more closely.
Patients Concern
Disease/Condition Glossary
Depression: It is a mood disorder characterized by the feeling of sadness, unhappiness, anger, hopelessness, or loss that interferes with a person’s daily activities. Depression can also influence some chronic health conditions and relationships. The exact cause of depression is unknown, but it may be associated with mental problems, trauma, family history, drug use and medical conditions.
FAQs
Nortriptyline contains 'Nortryptaline' that works by affecting certain chemical messengers (serotonin and/or norepinephrine) in the brain which communicate between brain cells, thereby helps in regulating mood and treats depression.
Do not take Nortriptyline if you are allergic to antidepressants (like nortriptyline, amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, trimipramine), antiallergic (like carbamazepine, eslicarbazepine, oxcarbazepine and rufinamide), and MAO inhibitors (like isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others). Besides this, if you have used an SSRI antidepressant in the last 5 weeks like escitalopram, fluoxetine, citalopram, fluvoxamine, paroxetine, sertraline, trazodone, or vilazodone let know doctor know about this.
No, you should not take Nortriptyline if you have had a recent heart attack or stroke. Taking Nortriptyline after a heart attack can worsen your present health conditions, Unless your doctor thinks the benefits overweigh the risks.
In some cases, Nortriptyline could make your skin sensitive and sunburn more easily. So, it is advisable to avoid sunlight or tanning beds. You can also wear protective clothing and use sunscreen (SPF 30 or more) when outside.
The common side effects of Nortriptyline include dizziness, blurred vision, headache, trouble with eye focusing, vision problems, constipation, dry mouth, high heartbeat (heart palpitation), tiredness, low blood pressure (especially on standing). Prolonged intake of Nortriptyline may increase the risk of eye pressure and heart attack. So, if you experience any of these symptoms immediately contact a doctor.
Nortriptyline could increase the pressure in your eyes. If you have a history of glaucoma or increased eye pressure, your doctor will monitor you more closely while you take nortriptyline.
No, If you have bipolar disorder that’s not being treated, taking nortriptyline can make your condition worse.
