nortriptyline, Pamelor, Aventyl - has been discontinued in the U.S.

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

What is nortriptyline, and how does it work (mechanism of action)?

Nortriptyline is in the class of drugs called tricyclic antidepressants (TCAs) and is used for treating depression. Other drugs in the same class include:

Individuals with depression may have an imbalance in neurotransmitters, chemicals that nerves make and use to communicate with other nerves. Like all TCAs, nortriptyline increases levels of norepinephrine and serotonin, two neurotransmitters, and blocks the action of acetylcholine, another neurotransmitter. It is believed that by restoring the balance of these different neurotransmitters in the brain depression is alleviated (for example, the mood is elevated).

Nortriptyline was approved by the FDA in November 1964.

What brand names are available for nortriptyline?

Pamelor (The brand name Aventyl has been discontinued in the US)

Is nortriptyline available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for nortriptyline?

Yes

What are the side effects of nortriptyline?

The most commonly encountered side effects associated with nortriptyline include:

Rare side effects include:

Nortriptyline also can cause elevated pressure in the eyes of some patients with glaucoma.

Overdoses of nortriptyline can cause life-threatening abnormal heart rhythms or seizures.

If nortriptyline is discontinued abruptly, headache, nausea, and general discomfort may occur. Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.

Antidepressants increased the risk of suicidal thinking and behavior in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of nortriptyline or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thinking or behavior, and unusual changes in behavior.

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