Nortriptyline: What is it? and Precautions to Take into Account

What is it?

Nortriptyline is a tricyclic antidepressant, one of the first groups and, therefore, the oldest and most studied types of antidepressants.

How is it used?

The presentation in capsules avoids the fractionation of the dose, which is unnecessary because there are many presentations of 10, 25, 50, and 75 mg. The recommended dose is 150 mg/day. The medicine should be distributed over most of the day and part of the night, for example, the fourth dose in the morning, afternoon, and a quarter of the night, thus generating minor side effects, therefore manifesting the outcomes more strongly while the patient is sleeping. To mitigate the side effects, the dose should be increased slowly and, at the end of the treatment, also removed slowly, with several days intervals between each reduction.

What does nortriptyline do in the body?

Its main indications are to treat depression, and among the tricyclic drugs, this is the most recommended for the elderly. It also effectively blocks panic attacks and inhibits nocturnal enuresis (urinating during sleep after having control already acquired).

The main side effects:

The main limitation of this medication is side effects that are often not well tolerated by patients.

  • The dryness of the mouth must be overcome with frequent small sips of water. You should avoid chewing gum and sugary sweets. A dental check-up is recommended every three months.
  • Constipation causes can be controlled with a diet rich in fiber such as wheat bran, which does not make you fat and facilitates intestinal transit; the bagasse of oranges is also very useful and healthy.
  • Increase in appetite and consequently weight gain. People with a tendency to gain weight should try to eat a balanced and healthy diet.
  • Blurred vision is a problem that must be overcome by reducing the dose, and the use of eye drops is not indicated.
  • The inhibition of sexual desire is proportional to the amount.
  • Generic effects such as headaches, dizziness, tinnitus, and decreased blood pressure when standing can even cause heart rhythm disturbances in people with previous problems.
  • All these problems disappear when the medication is stopped and generally improve when the dose is reduced.

Important considerations

This medicine should not be used in the following situations: patients with narrow-angle glaucoma, during the first trimester of pregnancy or breastfeeding, if they have an allergy to tricyclic antidepressants. Situations that require special attention are:

  • Patients with cardiac arrhythmias.
  • Hyperthyroidism with hepatic insufficiency in the use of tranylcypromine or other inhibitors.
  • Patients with epilepsy.