Nortriptyline, a tricyclic antidepressant, is sold under brand names like Pamelor and Aventyl. Approved by the U.S. Food and Drug Administration for depression, it's sometimes prescribed for anxiety and bipolar disorder too.
Nortriptyline, like other prescription drugs, comes with potential side effects. Here's a guide to watch out for while taking this medication:
Most Important Things About Nortriptyline:
- Severe side effects like hallucinations and seizures need immediate medical attention.
- Stopping or overdosing on nortriptyline can also cause side effects.
- Certain people shouldn't take nortriptyline, and it can interact with other medications.
Side Effects of Nortriptyline:
Common Side Effects:
- Blurred vision
- Constipation
- Dry mouth
- Increased appetite, craving sweets
- Ringing in the ears (tinnitus)
- Sedation
Nausea, nightmares, trouble urinating, excessive sweating, changes in sex drive.
- Potentially Serious Side Effects:
- Difficulty breathing or swallowing
- Fever or rash
- Irregular heartbeat
- Muscle spasms in jaw, neck, or back
- Shuffling when walking
- Trouble speaking
- Uncontrollable shaking
- Yellowing of eyes or skin
- Worsening depression or suicidal thoughts/behaviors
Discontinuing Nortriptyline:
- Stopping nortriptyline suddenly or reducing dosage significantly can lead to withdrawal effects like flu-like symptoms, headache, nausea, irritability, sleep issues, vivid dreams, and unusual excitement.
- Never stop taking medication without consulting your doctor.
- Gradual tapering or dose reduction may be recommended to minimize withdrawal effects.
Nortriptyline Overdose:
- Nortriptyline overdose can be life-threatening. Symptoms include severe side effects, confusion, convulsions, disturbed concentration, enlarged pupils, fast/slow/irregular heartbeat, restlessness, agitation, rigid muscles, severe drowsiness, shortness of breath, unusual tiredness, visual hallucinations, and vomiting.
- Seek immediate medical attention if overdose is suspected.
Contraindications and Interactions for Nortriptyline:
Contraindications:
- Taking monoamine oxidase inhibitor (MAOI) within 14 days
- Hypersensitivity to tricyclic antidepressants
- Recovering from a heart attack
Interactions:
- Anticholinergic medications (used for Parkinson's)
- Blood sugar-lowering medications (like chlorpropamide)
- Gastrointestinal medications (like cimetidine)
- High blood pressure medicines (like reserpine)
- Sympathomimetic drugs (used for glaucoma, COPD, etc.)
- Medications affecting serotonin levels/metabolism can lead to life-threatening serotonin syndrome (symptoms include dizziness, nausea, increased heart rate, delirium, and hallucinations).
- Alcohol can amplify nortriptyline's sedative effects. Avoid alcohol consumption while taking nortriptyline.
Summary:
Nortriptyline can cause side effects, including mild ones that may be bothersome. Knowing the potential effects can help you recognize them if they occur. If you experience new or worsening symptoms while starting or adjusting your nortriptyline dosage, discuss them with your healthcare provider. They can help find ways to reduce or eliminate these effects, like adjusting the dose or switching to a different medication.