Pamelor (Nortriptyline)

Description

Indications

Nortriptyline is indicated for the treatment of mental and mood disorders, such as depression. It may effectively enhance mood, promote a sense of well-being, alleviate anxiety and tension, and increase overall energy levels.

Classified as a tricyclic antidepressant, this medication exerts its therapeutic effects by modulating the balance of specific neurotransmitters in the brain, which are naturally occurring chemicals involved in transmitting signals between nerve cells.

Uses and Dosage

Administer this medication orally as instructed by your physician, typically 1 to 4 times daily.

When using the liquid formulation, ensure precise measurement using a specialized measuring device/spoon, as household spoons may not provide accurate dosing.

The dosage is determined based on your medical condition and response to treatment. To minimize the risk of side effects, such as dry mouth and dizziness, your doctor may initiate therapy with a low dose and gradually increase it.

Take this medication consistently to achieve optimal therapeutic benefits. Establish a routine by taking it at the same time(s) each day. Do not exceed the prescribed dose or frequency, and do not prolong the duration of use beyond what is directed. Increasing the dose or frequency will not accelerate improvement, but may heighten the risk of adverse effects.

Continue taking this medication even if you start feeling better. Do not discontinue it without consulting your doctor, as certain conditions may worsen upon abrupt discontinuation, leading to symptoms such as mood swings, headaches, fatigue, and changes in sleep patterns.

To prevent such symptoms during discontinuation, your doctor may gradually reduce your dose. Consult your doctor or pharmacist for detailed guidance. Promptly report any new or aggravated symptoms.

It may take some time for this medication to take full effect. Although you may notice some improvement within a week, it may take up to 4 weeks to experience the complete therapeutic effect.

Inform your doctor if your condition persists or worsens, such as increased feelings of sadness or suicidal thoughts.

Side Effects

Some side effects may occur that usually do not need medical attention:

• nausea
• drowsiness
• weakness or tiredness
• excitement or anxiety
• nightmares
• dry mouth
• changes in appetite or weight
• constipation
• difficulty urinating
• frequent urination
• changes in sex drive or ability
• excessive sweating

Inform your healthcare provider immediately if you experience any serious side effects:

• jaw, neck, and back muscle spasms
• slow or difficult speech
• shuffling walk
• uncontrollable shaking of a part of the body
• fever
• difficulty breathing or swallowing
• rash
• yellowing of the skin or eyes
• irregular heartbeat

Caution

Prior to initiating nortriptyline, inform your healthcare provider or pharmacist if you have a known allergy to nortriptyline, other tricyclic antidepressants (such as amitriptyline), or any other allergens. This medication may contain inactive ingredients that could trigger allergic reactions or other adverse effects.

Before using this medication, disclose your complete medical history, including any breathing problems, liver problems, recent heart attack, urinary issues (such as due to an enlarged prostate), hyperthyroidism, personal or family history of glaucoma (specifically angle-closure type), personal or family history of mental/mood conditions, family history of suicide, history of seizures, or any conditions that may increase your risk of seizures (such as other brain diseases, alcohol withdrawal).

Nortriptyline has the potential to cause a condition that affects the heart rhythm known as QT prolongation. QT prolongation can rarely lead to serious (and potentially fatal) symptoms such as fast or irregular heartbeat, severe dizziness, or fainting, which require immediate medical attention.

Low levels of potassium or magnesium in the blood may further increase the risk of QT prolongation. This risk may be heightened if you are concurrently taking certain medications (such as diuretics or “water pills”) or if you are experiencing conditions like severe sweating, diarrhea, or vomiting.

Nortriptyline may cause dizziness, drowsiness, or blurred vision. Concurrent use of alcohol or marijuana may intensify these effects. Avoid driving, operating machinery, or engaging in tasks that require alertness or clear vision until you are able to do so safely.

This medication may increase sensitivity to sunlight. Limit sun exposure, avoid tanning booths and sunlamps, and use sunscreen and protective clothing when outdoors. Notify your doctor immediately if you experience sunburn or skin blisters/redness.

If you have diabetes, this medication may interfere with the control of your blood sugar levels. Regular monitoring of blood sugar levels is recommended, and any changes should be promptly communicated to your doctor. Adjustments to your diabetes medication, exercise regimen, or diet may be necessary.

Older adults may be more susceptible to the side effects of this medication, particularly dry mouth, dizziness, confusion, difficulty urinating, and QT prolongation.

If you are pregnant, this medication should only be used if clearly needed and under the guidance of your doctor. Untreated mental/mood disorders, such as depression, anxiety, or panic disorder, can have serious consequences during pregnancy. Discontinuing this medication should only be done under the direction of your doctor. If you are planning to become pregnant, suspect that you may be pregnant, or are currently breastfeeding, it is crucial to discuss the potential benefits and risks of using this medication with your doctor.

This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Form and Strength

Pamelor is available in the following forms and strengths:

• nortriptyline capsule:
  • 10mg
  • 75mg

FAQ

How long does it take Pamelor to be effective?

You will need to take Pamelor every day for 1 to 2 weeks before you start feeling better, and for 6 to 8 weeks to feel the full effects of the medication.

What happens when you stop taking Pamelor?

Abruptly stopping treatment or missing doses of tricyclics like Pamelor can trigger more severe symptoms.

Resources

1. https://www.goodrx.com/nortriptyline/what-is
2. https://www.therecoveryvillage.com/pamelor-addiction/withdrawal-detox/#:~:text=Abruptly%20stopping%20treatment%20or%20missing,chills%2C%20nausea%2C%20and%20vomiting
3. https://medlineplus.gov/druginfo/meds/a682620.html
4. https://www.webmd.com/drugs/2/drug-1820/pamelor-oral/details
5. https://www.mayoclinic.org/drugs-supplements/nortriptyline-oral-route/side-effects/drg-20071998?p=1
6. https://www.drugs.com/mtm/pamelor.html