Some Precautions and Warnings With Nortriptyline
warnings and precautions to be aware of include:
- Antidepressants (including nortriptyline) may increase the risk of suicidal thoughts or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or develop new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include: anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thoughts or behavior (see Nortriptyline and Suicide for more information).
- Before prescribing nortriptyline for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes, the symptoms of bipolar disorder and depression are very similar, and nortriptyline can cause problems in people with bipolar disorder.
- Nortriptyline can make schizophrenia worse. Discuss this with your healthcare provider before taking nortriptyline.
- For people taking nortriptyline, caution should be used when driving, operating heavy machinery, or performing other tasks that require concentration, especially when first starting nortriptyline or when switching dosages. This is because nortriptyline may affect a person's mental or physical ability to perform these tasks. Make sure to understand how nortriptyline affects you before performing any task that requires mental or physical concentration.
- Nortriptyline can interact with certain medications (see Drug Interactions With Nortriptyline).
- Nortriptyline may enhance the effects of alcohol, barbiturates, and other medicines that affect the brain. This can lead to an increased risk for drowsiness, dizziness, suicidal thoughts, and other nortriptyline overdose symptoms. Make sure to talk with your healthcare provider about drinking alcohol while taking nortriptyline.
- Nortriptyline may not be safe for use during pregnancy. Discuss the benefits and risks of using nortriptyline during pregnancy with your healthcare provider (see Nortriptyline and Pregnancy for more information).
- Nortriptyline passes through breast milk and may cause harm to your baby. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about what makes the most sense for your particular situation (see Nortriptyline and Breastfeeding).
- Special care should be used when taking nortriptyline if you have a history of seizures, bladder problems, or glaucoma. Nortriptyline can make these conditions worse.
- Talk to your healthcare provider before taking nortriptyline if you have any heart problems, as nortriptyline can affect the heart and its electrical system.
- Talk to your healthcare provider before taking nortriptyline if you have hyperthyroidism (an overactive thyroid) or take thyroid medication.
- Taking nortriptyline while receiving electroshock or electroconvulsive therapy (ECT) can increase your risk of side effects. Talk to your healthcare provider about these risks.
- Nortriptyline may cause a dry mouth. Sucking on hard candy, chewing gum, or melting bits of ice in your mouth can provide relief.
- The elderly appear to be more sensitive to nortriptyline, which can increase their risk of side effects, such as delirium and confusion. In these particular situations, the healthcare provider will start people on lower doses of nortriptyline and monitor them more closely.
- If you have diabetes, make sure to check your blood sugar levels more often when starting nortriptyline or changing dosages. There have been reports of increased or decreased blood sugar levels in people who take nortriptyline.
- Do not treat yourself for the common cold, a cough, or allergies without first talking to your healthcare provider. Some of these medicines can increase the risk for developing nortriptyline side effects.
- Do not stop taking nortriptyline without first discussing it with your healthcare provider. Stopping the medicine abruptly may increase the risk for withdrawal symptoms (see Pamelor Withdrawal).