Nortriptyline ( Pamelor, Aventil ) data sheet


Nortriptyline is a tricyclic antidepressant medication. It is marketed in the U.S. under the brand names Pamelor® and Aventyl®. It received FDA approval for the treatment of depression in 1964. Although SSRIs, such as Paxil and Zoloft, are often the first choice of medication for depression, tricyclic antidepressants like nortriptyline are still frequently prescribed. They can be very effective, although the side effects may be less tolerable for some people.

What Nortriptyline Used to Treat

Nortriptyline is primarily used to treat depression, particularly endogenous depression (depression that has no apparent cause). However, it is often used “off-label” to treat or assist in the treatment of a variety of other disorders and health conditions. These include ADHD (when other therapies have not been successful), chronic pain, and anxiety disorders. It has also been used to help people stop smoking.

How it Works

Experts don’t fully understand how medications like Nortriptyline work. It is believed to help restore the balance of various chemicals in the brain, such as norepinephrine and serotonin. Norepinephrine and serotonin are neurotransmitters that play a significant role in the regulation of mood. By boosting these important chemicals, nortriptyline helps to reduce the symptoms of depression.

How it’s Administered

Nortriptyline is available as a tablet, capsule, or oral solution. It is often prescribed to be taken 3 or 4 times each day. Your doctor may start you on a low dose and gradually increase it to a therapeutic level. This gradual increase will help keep side effects to a minimum while your body adjusts to the medication. Let your doctor know if you are experiencing any adverse side effects.

Nortriptyline is not a fast-acting medication. While some benefits may be experienced after a week of starting the medication, the full benefits are usually not felt for at least 2 to 4 weeks. As with all medications, it’s vital that you take nortriptyline exactly as prescribed.

If the medication is effective, you may be tempted to stop it once you no longer have any symptoms. However, nortriptyline should not be discontinued abruptly. Although it’s not an addictive medication, you may experience unpleasant withdrawal symptoms if you don’t gradually taper down the dose. Withdrawal effects may include headaches, nausea, fatigue, and mood fluctuations. Follow your doctor’s instructions for safely stopping the medication.

Potential Side Effects

Like all medications, Nortriptyline may cause a variety of side effects ranging from mild to severe. A few of the more common side effects include:

  • Drowsiness
  • Weight gain
  • Difficulty urinating
  • Constipation
  • Dry mouth
  • Dizziness
  • Blurred vision
  • Erectile problems
  • Decreased libido
  • Increased sweating

Other potential side effects may include (but aren’t limited to):

  • Serious allergic reaction
  • Abdominal pain
  • Fainting
  • Muscle spasms
  • Elevated heart rate
  • Heart palpitations
  • Seizures
  • Suicidal thoughts
  • Swollen, painful breasts
  • Anxiety
  • Restlessness
  • Severe mood swings
  • Changes in blood sugar levels
  • Psychosis
  • Disturbed sleep

Some side effects may subside as your body adjusts to taking Nortriptyline. Be sure to discuss any side effects with your doctor.


Before you take nortriptyline, it’s very important that you talk to your doctor about any current or past medical and mental health conditions. If you are a woman, be sure to inform your doctor if you are pregnant or nursing, or thinking about getting pregnant. It’s also important to let your doctor know about any other medications you are taking, as well as any supplements.

Nortriptyline should be taken with extreme caution if you have a family history of bipolar disorder, or a history of manic or hypomanic episodes. Caution should also be used if you have schizophrenia, as nortriptyline may exacerbate psychotic symptoms.

Antidepressant medications may increase suicidal thoughts in some individuals, particularly children, adolescents, and young adults. This is why it’s important that any changes in mood or behavior are closely monitored by your doctor.

Drinking alcohol while taking nortriptyline can be dangerous, as the medication may increase the effects of alcohol.

Additional Considerations

While medication can be very beneficial in the treatment of depression, the most effective long-term treatment is psychotherapy or a combination of medication and psychotherapy. Medication alone doesn’t address the underlying issues that typically cause or at least play a significant role in depression and other disorders.

One of the most effective types of therapy for depression (as well as many other mental health disorders and emotional issues) is cognitive behavioral therapy. A skilled therapist can help you gain valuable insight into your depression, as well as help you identify and change unhealthy thoughts and behaviors that may be playing a part.


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