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.

Understanding Depression Slideshow

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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: 10, 25, 50, and 75 mg. Oral solution: 10 mg/teaspoon

STORAGE: Nortriptyline should be stored below 30 C (86 F) in a tight, light resistant container.

DOSING:

Adults: The usual dose of nortriptyline in adults is 25 mg given 3 to 4 times daily. The total daily dose can also be given at night. The maximum dose is 150 mg daily. The optimal blood levels are 50 to 150 ng/ml.

Children >13 to 18 years old: Doses usually are 30 to 50 mg once daily or in divided doses for children >13 to 18 years old. It is advisable to begin at a low dose and increase the dose slowly.

Medically Reviewed by a Doctor on 12/19/2014

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Depression Hurts: Physical Symptoms of Depression
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