Nortriptyline hydrochloride (
Pamelor®) is a prescription medication that is used to treat
depression (also known as major depression or clinical depression).
Nortriptyline is made by Mallinckrodt Pharmaceuticals. It is sold under the brand name Pamelor. Generic nortriptyline is made by several different manufacturers.
How Does Nortriptyline Work?
Nortriptyline belongs to a class of medications called
tricyclic antidepressants. It is not entirely clear how the medication works. However, it does affect several chemicals in the brain, including serotonin and norepinephrine. The medication may allow these chemicals to stay in the brain longer, which can help with
symptoms of depression.
Some considerations for when and how to take nortriptyline include the following:
- The medication comes in capsule form. When used for depression, it is usually taken by mouth one to four times daily.
- For people with trouble swallowing capsules, a liquid form is also available.
- You can take nortriptyline with or without food. If the medication upsets your stomach, try taking it with food.
- Nortriptyline should be taken at the same time(s) each day to maintain an even level in your blood.
- For the medication to work properly, you have to take it as prescribed. Nortriptyline will not work if you stop taking it.
The dose of nortriptyline your healthcare provider recommends will vary, depending on a number of factors, including:
- Your age
- Other medical conditions you may have
- Other medications you may be taking.
As with any medication, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
Side Effects of Nortriptyline
As with any medicine, side effects are possible with nortriptyline. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it well. If side effects do occur, they are often minor and either require no treatment or can easily be treated by your healthcare provider. Serious side effects are less common.
Common side effects include:
(Click Nortriptyline Side Effects to learn more, including some of the more serious side effects that you should report to your healthcare provider.)
You can also read about specific side effects in the following eMedTV articles:
What Should I Tell My Healthcare Provider Before Taking Nortriptyline?
Talk with your healthcare provider prior to taking this drug if you have:
Also, let your healthcare provider know if you:
Be sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Depression, even in its most severe form, is highly treatable. As with many illnesses, getting
depression treatment early is more effective and reduces the chance of recurrence.
The most common forms of treatment for depression are medication (
antidepressants) and psychotherapy ("talk therapy"). In severe cases, some healthcare providers may recommend electroconvulsive therapy (ECT). Some people may also try complementary or alternative treatments for depression
(see Natural Remedies for Depression).
For most people, nortriptyline is quite effective at treating depression. It is also generally well tolerated. However, side effects can occur or the medicine may not work as well as needed. In these cases, your healthcare provider may recommend an alternative. Some examples of substitute depression medications include:
What If I Take an Overdose?
People who take too much nortriptyline may have overdose symptoms that could include:
- Changes in heart rhythm (arrhythmia)
- Very low blood pressure (hypotension)
- Congestive heart failure
- Lung problems
- Seizures
- Sleepiness or fainting
- Confusion
- Restlessness
- Seeing things that are not really there (hallucinations)
- Dilated (wide open) pupils
- Agitation
- Vomiting
- Fever
- Loss of life.
An overdose can be dangerous. If you happen to take too much, seek immediate medical attention.
How Should Nortriptyline Be Stored?
Nortriptyline should be stored at room temperature, away from moisture and heat. Both the capsules and the oral solution should be kept in an airtight container.
Keep this and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your nortriptyline as scheduled, take your missed dose as soon as you remember. However, if you usually take your dose at night, you may not want to make up the missed dose during the day because of the risk of drowsiness. Also, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Nortriptyline capsules are available in the following strengths:
- Nortriptyline 10 mg
- Nortriptyline 25 mg
- Nortriptyline 50 mg
- Nortriptyline 75 mg.
The liquid form is available in one strength -- Nortriptyline oral solution 10 mg per 5 mL (10 mg per teaspoonful).
There are currently both brand-name and generic versions of nortriptyline licensed for sale
(see Generic Pamelor for more information).
