Pamelor is a brand name of the antidepressant nortriptyline. Nortriptyline is a second-generation tricyclic antidepressant. Second generation tricyclics have more moderate side effects than the first generation of tricyclics. Pamelor is less likely to cause anticholinergic symptoms like constipation, dry mouth, and blurred vision. They’re also less sedative and less likely to cause weight gain.
Tricyclics are safe to take for the treatment of depression while in recovery for addiction to other substances. To avoid complications, individuals who take tricyclics like Pamelor should contact their doctor if they return to taking recreational drugs.
Tricyclics treat depression by inhibiting the reuptake of the neurotransmitters serotonin and norepinephrine. Depression can be caused by deficiencies in these important neurotransmitters. By delaying reuptake of serotonin and norepinephrine, Pamelor increases thei impact on brain function. Norepinephrine’s job is to mobilize the body for action by increasing focus and alertness. Serotonin is involved in a wide variety of functions including digestion, appetite, mood, memory, sleep, sex drive, and social behavior.
Not all types of depression are caused by deficiencies in serotonin or norepinephrine. Types that are the result of these deficiencies may respond well to treatment with a tricyclic like nortriptyline. Tricyclics are usually tried as a treatment for depression only after selective serotonin reuptake inhibitors (SSRIs) fail. SSRIs are a newer generation of antidepressants that focus solely on delaying the reuptake of serotonin molecules. Doctors and psychiatrists tend to start new patients out on an SSRI like Prozac because they have the highest success rate and less severe side effects.
Recent studies suggest that long-term treatment with a tricyclic like Pamelor can lead to the development of irreversible dementia. They also can have more severe side effects. Possible side effects of nortriptyline include sedation, increased appetite, dry mouth, blurred vision, constipation, and tinnitus (ringing in the ears). On occasion, rapid or irregular heartbeat can occur. Mixing alcohol with Pamelor increases the chance of cardiac-related side effects.
Nortriptyline and other tricyclics are not considered to be addictive; however, they do cause withdrawal symptoms when patients stop taking them. The scientific community refers to antidepressant withdrawal symptoms as discontinuation syndrome.
Abruptly stopping treatment or missing doses of tricyclics like Pamelor can trigger more severe symptoms. Common discontinuance symptoms of nortriptyline include anxiety, muscles pain, dizziness, headache, chills, nausea, and vomiting.
Withdrawal symptoms can begin within 24 hours of stopping treatment or missing a dose. After three to five days symptoms can reach their most severe levels. For most patients, symptoms peak around day five. Patients report that it can take up to three months before they begin to feel normal following complete cessation of the drug. On average, symptoms of discontinuation syndrome resolve within two to three weeks. Symptoms and symptom durations can vary significantly dependent upon the individual, but negative effects can be minimized under the guidance of a medical professional.
Nortriptyline is commonly prescribed for the treatment of depression, but it can also be used to help reduce occurrences of bedwetting in adolescents. Pamelor is occasionally prescribed for chronic pain, migraines, and to reduce the symptoms of specific neurological disorders.
Doctors encourage patients to be physically active during the discontinuation phase. Exercising three days a week for 20 minutes at a time can greatly decrease symptoms of depression. Talk to your doctor if you want to stop taking Pamelor. Symptoms of discontinuation syndrome can also be greatly reduced by gradually lowering the dose over the course of several weeks.
Tricyclic antidepressants like nortriptyline are much less frequently prescribed than the more recent generation of selective serotonin reuptake inhibitors (SSRIs). It stands, however, that in cases of melancholic depression, drugs like Pamelor have a much higher success rate than SSRIs. Melancholic depression is a particularly severe form of depression that usually presents along with either major depressive disorder (MDD) or bipolar disorder.
Melancholic depression is characterized by psychomotor disturbances, excessive guilt, severe weight loss, loss of appetite, lack of mood reactivity, and the inability to find enjoyment in positive things.
Patients with melancholic depression should be especially careful when stopping treatment with nortriptyline. Discontinuation syndrome can become severe if doses are not gradually decreased.
If you’re looking for a psychiatrist to prescribe an antidepressant that works for you, such as nortriptyline, it can take several tries. Many new patients see up to three to five psychiatrists before they find someone that works for them. It’s important to find a doctor who can accurately gauge the patient’s needs. Because of the link that exists between tricyclic use and increased rates of dementia, tricyclics should only be prescribed when medications with fewer side effects fail to work.
Tricyclics like Pamelor are advisable for patients to take while in recovery for substance use disorder. Nortriptyline is not known to strengthen drug cravings or to increase the likelihood of recurrence of use.
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The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.