Symptoms of depression can be treated using Nortriptyline

Nortriptyline belongs to class of tricyclic antidepressants. It works by affecting the chemicals present in your brain that may get imbalanced in people suffering from depression. It is basically used to treat various symptoms of depression. The generic name is Nortriptyline and brand name is Aventyl HCl and pamelor.

Important Information

Avoid using Nortriptyline if you had a heart attack recently or if you have an allergy to some medicines.

In case you have used MAO inhibitor in last 14 days, then avoid using this medicine.

In some cases people often get suicidal thoughts when they take the medicine for the first time. Your doctor will ask you to visit regularly in order to monitor the progress while you are on Nortriptyline. Your care givers or family members should be alert and monitor mood changes or related symptoms.

Report in case of any worsening or new symptoms to your health care provider like behavioural changes or mood changes, trouble sleeping, feel impulsive, hostile, agitated, irritable, panic attacks, anxiety, restless, aggressive, hyperactive or more depressed, suicidal thoughts or thinking about hurting yourself.

Avoid using Nortriptyline if

  1. you recently had an heart attack
  2. you are allergic to some similar antidepressant like clomipramine, amoxapine, doxepin, Amitriptyline, trimipramine or imipramine
  3. you are allergic to specific seizure medications like oxcarbazepine, rufinamide, , eslicarbazepine,carbamazepine,

Avoid using Nortriptyline if you have used MAO in last 14 days like , linezolid, isocarboxazid ,methylene blue injection, selegiline, rasagiline, tranylcypromine, phenelzine as it can result in serious drug interactions.

To ensure if Nortriptyline is safe for you or not, speak to your health care provider and let him know if are suffering from

  • heart disease, have a history of heart stroke, heart attack or seizures
  • liver disease
  • thyroid disorder
  • urination problems
  • glaucoma (narrow angle)
  • mental illness or schizophrenia
  • bipolar disorder
  • diabetes

Use Nortriptyline as prescribed by your doctor. Read the label and follow the directions. Your doctor can change your dose very often to get positive results. Do not use Nortriptyline in high doses or for a prolonged period.

If you are undergoing a surgery, inform your doctor in advance that you are taking Nortriptyline. You might need to stop taking the medicine for some time. Do not stop using Nortriptyline suddenly as you can experience unwanted withdrawal symptoms. Consult your physician to know how to stop taking the medicine safely.

It takes a couple of weeks to see improvement in symptoms of depression. Keep taking the medicine as prescribed by your doctor and if the symptoms do not improve, let your doctor know about it.

Store the medicine away from heat and moisture in a room temperature.

Is Nortriptyline addictive?

Nortriptyline is not addictive, but halting use of Nortriptyline can result in withdrawal symptoms like nausea and headache. So speak to your doctor as he can adjust the doses and slowly decrease the dose before you actually quit Nortriptyline. This will help you avoid unwanted withdrawal symptoms.

Right Nortriptyline dosage for treating depression

Taking the right dosage of Nortriptyline as prescribed by your doctor can help you get maximum drug benefits. You should follow your doctor’s instructions and avoid halting the use of Nortriptyline suddenly. Speak to your doctor before you start using Nortriptyline.

Your drug form, dosage and frequency of the dose depends on

  1. your age
  2. how severe your current medical condition is
  3. other medical problems that you have
  4. how you respond to the initial dose

Normal Adult dose – for depression

25mg to be taken orally – 3-4 times a day

maximum dose: 150mg to be taken orally per day

Note: Plasma levels needs to be monitored and maintained effectively in the range of 50-150 ng/mL., in case the dose given is above 100mg/day.

The dosage of Nortriptyline should be decreased if the patient experiences minor side effects.

The drug should be stopped in case serious allergic symptoms are seen.

The total dose (daily) should be taken once in a day.

Normal Senior dosage for people aged 65 years and above – for depression

The recommended dose for this section is 30-50mg once in a day or in split doses.

Maximum daily dose is 150mg

Normal Geriatric dose – for depression

30-50mg to be taken orally in split doses.

The total dose (daily) should be given once in a day.

Dosage for children

The drug can be used in adolescents and should avoid using it in children who are not of adolescent age. You can check with your doctor for right dosage for a particular age group.

If I miss a dose

In case you miss a dose, take the missed dose as soon as it strikes you else skip the missed dose if it is almost the time for your next dose. Do not take extra dose to make up for the missed dose

If I overdose

Call medical help or poison control centre immediately.

Nortriptyline and Over dosage treatment

Do not take Nortriptyline in excess as accumulation of too much of drug in your body can be dangerous and overdose of Nortriptyline can result in death, low BP, lung problems, seizures, irregular heart beat. If you feel you have used Nortriptyline in excess call emergency medical help or poison control centre immediately.

In case of overdose the doctors obtain ECG and start cardiac monitoring. They also protect airway and start with gastric decontamination. The patients is monitored for minimum 6 hours to check for signs of respiratory or CNS depression, hypotension, seizures, conduction blocks etc., if the signs of toxicity appear again during the observation period, the observation period is extended. Most patients succumb to death after overdose as they do not get immediate medical help or sufficient gastrointestinal decontamination.

Overdose can be fatal and needs immediate treatment to remove the toxins of the drug out of your body. So the first thing that should be done is to seek medical help or call poison control. Patient’s life can be saved if he gets right treatment on right time.

Learning about side effects of Nortriptyline while treating depression

Nortriptyline is used to treat various symptoms of depression. While you are on Nortriptyline, you can encounter various side effects too. Some of these can be mild whereas some are major side effects that need medical help. Let us learn about the various side effects of Nortriptyline depending upon their severity.

Major side effects that need emergency medical help

  • blurred vision
  • agitation
  • cold sweats
  • depression
  • decreased urination
  • double vision
  • feeling of warmth
  • hostility
  • irritability
  • hyperventilation
  • nightmares
  • restlessness
  • slurred speech
  • seizures
  • perspiration
  • panic
  • trouble sleeping
  • sweating
  • burning, itching, crawling, numbness and tingling feelings
  • chest discomfort or pain
  • confusion about identity, time or place and false beliefs
  • continuing buzzing or ringing noise in ears
  • speech problems
  • light-headedness, faintness or dizziness when rising suddenly from sitting or lying position
  • irregular, pounding or fast pulse or heart beat
  • seeing, feeling and hearing things that doesn’t exist
  • weakness or tiredness
  • inability to move facial, legs and arms muscles
  • loss of balance
  • side pain or lower back pain
  • muscle stiffness, jerking or trembling
  • muscles spasms
  • difficult or painful urination
  • purple or pinpoint red spots on skin
  • redness of arms, face or neck
  • sores, white spots or ulcers in mouth or on lips
  • limb stiffness
  • swelling of ankles, face, hands or legs
  • feeling, acting or talking with excitement
  • uncontrolled movements of back, neck and face
  • weakness in feet, legs, hands and arms

Minor Side effects

Some side effects do not need medical attention as they disappear with time. Once your body gets used to the medication minor side effects disappear on their own. But if these side effects continue for a long and bother you, speak to your doctor as you need immediate medical attention.

Occurrence not known

  • black tongue
  • severe sunburn
  • heartburn
  • hair thinning or hair loss
  • dilated, bigger or enlarged pupils
  • decreased ability or interest in sexual intercourse
  • increased in sexual  desire or ability
  • peculiar taste
  • difficulty with bowel movement
  • welt or hives
  • discomfort or pain in throat, upper stomach or chest
  • increased eye sensitivity to light
  • enlargement of breasts
  • increase in sexual drive, ability, desire or performance
  • discoloration or redness of skin
  • swollen testicles
  • inflammation or swelling of mouth
  • waking at night to urinate
  • vision changes
  • painful, tender or swollen lymph glands on the side of neck or face

The above mentioned side effects should not be ignored. Your health care provider can help you know how to reduce these side effects or prevent them. In case you notice any unusual symptom contacts your physician immediately.

Your doctor knows about all possible effects and can treat you effectively. This will help you get maximum benefits of the drug.

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