Pamelor Addiction Treatment and Rehab

Pamelor is a brand name of the tricyclic antidepressant nortriptyline. Tricyclics like nortriptyline treat depression by addressing deficiencies in the expression of serotonin and norepinephrine. Serotonin is a neurotransmitter in the brain that’s responsible for feelings of general well-being. Deficiencies in serotonin have been strongly linked to depression. Norepinephrine is another neurotransmitter with a strong correlation to depression. Norepinephrine is involved in a variety of functions: mood, attentiveness, sleeping and learning.

Tricyclics were, for many years, the first line of antidepressants prescribed for most types of depression. Today, selective serotonin reuptake inhibitors (SSRIs) are usually prescribed first to new patients. SSRIs have higher success rates and fewer side effects than tricyclics. Tricyclics are still commonly prescribed for the treatment of melancholic depression, a particularly severe form that can accompany bipolar disorder and major depressive disorder (MDD). Nortriptyline may also be prescribed for chronic pain migraines and childhood bedwetting.

Nortriptyline is part of the second generation of tricyclic antidepressants. Nortriptyline has the same mechanism of action as first generation tricyclics but isn’t as likely to cause severe dry mouth and constipation. Other side effects of tricyclics like Pamelor can include blurred vision, drowsiness, difficulty urinating, dizziness and weight gain.

Many patients find that dry mouth can be mitigated by chewing sugar-free gum or candy and drinking plenty of water. Constipation can be avoided by drinking adequate water, eating plenty of fiber and exercising.

Pamelor is considered non-addictive. In fact, if you’re seeking treatment for addiction to alcohol, recreational drugs or prescription pharmaceuticals like Xanax or opioids, your doctor may still prescribe Pamelor for the treatment of depression.

Missing doses or abruptly stopping treatment can result in more severe withdrawal symptoms. Although nortriptyline is considered to be non-addictive, patients still experience adverse side effects upon cessation of use. Withdrawal symptoms from antidepressants are referred to by the medical community as “discontinuation syndrome.” Discontinuation syndrome from antidepressants is considered to be different than withdrawals from addictive substances. Discontinuation syndrome from nortriptyline is usually easy to manage under the guidance of a doctor.

Talk to your doctor if you want to stop taking Pamelor. Abruptly stopping treatment with tricyclics can lead to more intense withdrawal effects. These symptoms can include fatigue, loss of appetite, apathy, mania, drowsiness, inflammation of the nasal cavities, malaise, muscle aches, night terrors, irritability, headaches, diarrhea, worse depression, excessive sweating and abdominal pains.

The severity of withdrawal symptoms seems to be affected by the length of time the patient has been taking Pamelor. One study indicates that patients who are on Pamelor for two months or less experience significantly milder symptoms of discontinuation syndrome. For individuals who have been taking nortriptyline for longer, symptoms can often include movement disorders like difficulty initiating movements, general rigidity and akathisia (restlessness under the skin).

Rehabilitation programs aren’t a necessary part of detoxing from nortriptyline because tricyclics aren’t considered to be addictive. However, adjusting to being off antidepressants is rarely a comfortable process. The most important factor is to gradually decrease the dose over the course of several weeks. A common practice for most doctors is to decrease the dose once every two weeks. This gives the patient adequate time to acclimate to the lower quantity of nortriptyline rather than shocking the brain by removing it all at once.

Luckily, because tricyclics like Pamelor are non-addictive, patients don’t have to deal with cravings for the drug. Withdrawals tend to be most severe in patients who abruptly stop treatment without first consulting their doctor. Even when doses are titrated gradually, discontinuation syndrome can still be disruptive to daily life.

Your doctor, family and close friends will be your support system as you adjust to no longer taking Pamelor. Discontinuation syndrome usually begins within the first 24 hours when doses are missed or treatment is abruptly halted.

Symptoms become most severe between three and five days following cessation of treatment. Many patients state that it can take as many as 90 days before they feel “back to normal.” When doses are gradually reduced, most patients return to baseline within two to three weeks after their final dose.
During this time, it’s especially important to share any increase in symptoms with your doctor. If symptoms of depression get worse, your doctor may decide that it’s appropriate to briefly increase your dose or introduce other medications. With the right care, most patients find withdrawal from tricyclics to be easy to manage.

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