What Meds

Psychiatric Medications


Nortriptyline hydrochloride
Brand Name: Pamelor, Aventyl

Overview
Nortriptyline is a tricyclic antidepressant and antineuralgic. It works by inhibiting norepinephrine and serotonin reuptake and blocking histamine and acetylcholine, restoring levels of norepinephrine and serotonin in the brain.

Nortriptyline’s effects usually may be felt within a few days to two weeks.

Why is this drug prescribed?
Nortriptyline is FDA-approved for depression in children age 6 and up and in adults.

Nortriptyline is used primarily to treat depression, especially endogenous depression.
It is also used to treat:

How much of this drug is typically used?
Capsule: 10, 25, 50, 75mg
Oral Solution: 10mg/5ml
Tablet: 25mg

Warnings
Nortriptyline should not be given to children under 12 years old. Nortriptyline should only be given to adolescents under 18 who are under the care of a child psychiatrist. For adolescents 12-18 a reduced dosage may be needed.

Nortriptyline is not addictive. Suddenly discontinuing Nortriptyline may cause withdrawal symptoms such as headache and nausea; dosage should be gradually tapered.

Nortriptyline can cause photosensitivity and can reduce sweating which impairs the body's ability to adapt to heat. Patients should avoid saunas and other very hot environments.

Nortriptyline can impair concentration and coordination. Patients should not drive or operate heavy machinery until they know that this drug does not impair their ability to safely engage in such activities.

For Pregnant or Nursing Mothers: Studies of Nortriptyline during pregnancy and lactation are not conclusive, and the effects of Nortriptyline on the fetus or infant are not known.

Contraindications
Nortriptyline should Not be used for people with the following medical conditions:

Precautions
Nortriptyline may be given with caution to people with the following conditions:

Adverse Reactions
Nortriptyline may cause the following reactions:

Rarely:

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Nortriptyline are:

Research Studies and Use in Child Psychiatry
Nortriptyline is FDA-approved for treating depression in children, though because of its side effects, its use has decreased dramatically since the introduction of the SSRIs. It is one of the tricyclic antidepressants used to treat enuresis (bed-wetting) in children. It is also used to treat migraine headaches in children, as well as pain from nerve inflammation.

There is also at least one study of showing that nortriptyline is effective in reducing both ADHD and oppositional symptoms in children and adolescents. However, the tricyclic antidepressants are not commonly used to treat ADHD because of the availability of safer alternatives.

Sources

Stanford Medicine Resources:

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