Nortriptyline is the generic name for the brand name antidepressant Pamelor. Nortriptyline is one of many versions of tricyclic antidepressants. Major depressive disorder (MDD) is one of the most common mental health disorders worldwide. The first generation of tricyclics was invented in the 1950s; Pamelor is a second-generation tricyclic. Tricyclics treat depression by addressing the neurotransmitter imbalances that can be at the root of symptoms.
Second generation tricyclics like nortriptyline have less severe side effects. Side effects for this course of treatment include tiredness, an increased appetite, tinnitus (ringing in the ears), constipation, blurred vision, and dry mouth.
Pamelor should not be mixed with alcohol because the side effects may be amplified.
Occasionally, patients experience rapid or irregular heartbeat. There is a small risk of more advanced cardiac side effects in some patients. QT prolongation is a dangerous medical condition that increases when taking Pamelor alongside other drugs. It is very important to inform your doctor if you have a history of heart problems and to share a list of all current medications. Low levels of magnesium and potassium in the blood is an additional risk factor for QT prolongation while taking Pamelor.
Nortriptyline is prescribed mostly as a treatment for depression. Most doctors choose to prescribe tricyclics as the second line of treatment, after first trying a selective serotonin reuptake inhibitor (SSRI). SSRIs like Prozac are part of a newer generation of antidepressants that have a higher success rate and less serious side effects compared to tricyclics.
Tricyclics like Pamelor, however, have a higher success rate than SSRIs for the treatment of melancholic depression. Melancholic depression is a severe form of depression that’s characterized by extreme apathy and the inability to feel pleasure even when positive things happen.
Other applications for nortriptyline include treatment for chronic pain, migraines, neurological disorders, and childhood bedwetting. To reduce the severity of side effects when starting treatment with Pamelor, small doses will initially be prescribed, followed by a gradual increase in dose.
Pamelor is not considered to be addictive by both the federal government and the medical community. Patients will go through discontinuance symptoms upon stopping treatment, but symptoms are generally mitigated under the guidance of a medical professional.
Aftercare with the support of a doctor is critical when transitioning off a nortriptyline regimen. Missing doses or abruptly stopping nortriptyline can cause more severe withdrawal symptoms to occur. Withdrawal from antidepressants is referred to as “discontinuation syndrome.” It’s considered to be different than withdrawals from recreational drugs and other prescription medications because this experience is comparatively mild and can be managed by gradually reducing dosages.
Let your doctor know if you’d like to stop taking Pamelor. This is especially important for patients that have been taking the drug for a long duration or at high doses. Withdrawals can be minimized by slowly decreasing the dose over the course of several weeks. Quickly stopping the drug can trigger increased feelings of depression.
One of the reasons that nortriptyline isn’t prescribed as frequently as SSRIs is because of the strong link that has been established between the onset of irreversible dementia and the extended use of tricyclics. This makes aftercare even more critical with nortriptyline compared to other antidepressants. For many patients, it can take several months before they start to feel “normal” following the cessation of treatment.
If you or a loved one is struggling with substance use disorder, don’t delay. We have a wonderfully trained team ready to answer any questions about issues with Pamelor (nortriptyline) or substance use disorder.
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