Nortriptyline Treatment Report

Category: Prescription Drugs

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Generic Name: Nortriptyline

What is Nortriptyline?

An example of Nortriptyline

Nortriptyline is a tricyclic antidepressant used in the treatment of depression. Off label it is used for chronic pain, anxiety disorders, bedwetting in children, attention-deficit/hyperactivity disorder (ADHD); and as an adjunctive therapy for smoking cessation.

Reported Purpose & Perceived Effectiveness

Reasons and Perceived effectiveness
Perceived Effectiveness
Purpose # of patients # of patients with evaluations
Major
Moderate
Slight
None
Can’t tell
136 38 Efficacy_major Efficacy_moderate Efficacy_slight Efficacy_none Efficacy_cant_tell
128 42 Efficacy_major Efficacy_moderate Efficacy_slight Efficacy_none Efficacy_cant_tell
105 32 Efficacy_major Efficacy_moderate Efficacy_slight Efficacy_none Efficacy_cant_tell
50 18 Efficacy_major Efficacy_moderate Efficacy_slight Efficacy_none Efficacy_cant_tell
41 22 Efficacy_major Efficacy_moderate Efficacy_slight Efficacy_none Efficacy_cant_tell
34 11 Efficacy_major Efficacy_moderate Efficacy_slight Efficacy_none Efficacy_cant_tell

See all 487 patients currently taking Nortriptyline

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Reported Side Effects

Side effects as an overall problem

Severe
34
Moderate
55
Mild
45
None
66

Commonly reported side effects, conditions, and hospitalizations associated with Nortriptyline

36
17
13
9
7
5
See all 108 reported side effects See top 6 reported side effects

Reported Dosages

Frequently reported dosages based on patients currently taking Nortriptyline. See all 30 dosages

  10 mg daily 20 mg daily 25 mg daily 30 mg daily 40 mg daily 50 mg daily 60 mg daily 75 mg daily 100 mg daily 150 mg daily
  81 Number of Patients: 81 58 Number of Patients: 58 89 Number of Patients: 89 31 Number of Patients: 31 13 Number of Patients: 13 120 Number of Patients: 120 4 Number of Patients: 4 53 Number of Patients: 53 40 Number of Patients: 40 10 Number of Patients: 10  

Reported Stop Reasons

Why Patients Stopped Taking Nortriptyline (multiple reasons could be selected)
Reason # Patients Percentage of patients
Side effects too severe 89   Side effects too severe: 41%
Did not seem to work 85   Did not seem to work: 39%
Doctor's advice 58   Doctor's advice: 27%
Other 37   Other: 17%
Personal research 15   Personal research: 7%
Course of treatment ended 12   Course of treatment ended: 6%
Expense 6   Expense: 3%
Not indicated 5   Not indicated: 2%
Change in health plan coverage 1   Change in health plan coverage: 0%

See all 215 patients who’ve stopped taking Nortriptyline

Currently Taking Nortriptyline

A bar graph

0-1 month 1-3 months 3-6 months 6 months-1year 1-2 years 2 years or more
0

Stopped Taking Nortriptyline

A bar graph

0-1 month 1-3 months 3-6 months 6 months-1year 1-2 years 2 years or more

Reported Adherence, Burden & Cost See details from patient evaluations

Adherence

Taking treatment as prescribed

Adherence of Nortriptyline

Always
164 82%
Usually
27 14%
Sometimes
6 3%
Never
3 2%

Burden

Difficulty being on treatment

Burden of Nortriptyline

Very
7 4%
Somewhat
11 6%
A little
30 15%
Not at all
152 76%

Cost

Paid out of pocket

Cost of Nortriptyline

$200+
0 0%
$100-199
0 0%
$50-99
0 0%
$25-49
3 2%
< $25
119 98%

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33 patient evaluations for Nortriptyline

Purposes: Depressed mood and Pain (Started Dec 15, 2010)
Date Dosage Depressed mood Perceived effectiveness Pain Perceived effectiveness Side Effects Adherence Burden
Mar 04, 2013 50 mg Daily Led_efficacy_3Led_efficacy_3Led_efficacy_3Led_defaultModerate Led_efficacy_4Led_efficacy_4Led_efficacy_4Led_efficacy_4Major NoneNoneNoneNoneNone AlwaysAlwaysAlwaysAlwaysAlways Not at allNot at allNot at allNot at allNot at all
  • Icon_thumb_off 0 helpful marks
  • DDM65
    Sex: F
    Data Quality: 3 stars
    MS: 7 yrs
    Type: Relapsing-Remitting
    Sensation: Moderate
    Overall: Mild
    Cognition: moderate
    Vision: moderate
    Speech: mild
    Swallowing: moderate
    Upper limb: moderate
    Walking: mild
  • Portrait_default_thumb
  • See DDM65's full Nortriptyline history
Purpose: Depressed mood (Started Dec 01, 2009)
Date Dosage Perceived effectiveness Side Effects Adherence Burden
Dec 18, 2012 150 mg Daily Led_efficacy_2Led_efficacy_2Led_defaultLed_defaultSlight NoneNoneNoneNoneNone AlwaysAlwaysAlwaysAlwaysAlways Not at allNot at allNot at allNot at allNot at all
  • Icon_thumb_off 0 helpful marks
Purpose: Unrefreshing or poor sleep (Started Dec 15, 2011)
Date Dosage Perceived effectiveness Side Effects Adherence Burden
Oct 25, 2012 50 mg Daily Led_efficacy_3Led_efficacy_3Led_efficacy_3Led_defaultModerate MildMildMildMildMild AlwaysAlwaysAlwaysAlwaysAlways A littleA littleA littleA littleA little
Date
Oct 25, 2012
Advice & Tips
Upped dose is all
  • Icon_thumb_off 0 helpful marks
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What is nortriptyline?

Nortriptyline is in a group of drugs called tricyclic antidepressants. Nortriptyline affects chemicals in the brain that may become unbalanced.

Nortriptyline is used to treat symptoms of depression.

Nortriptyline may also be used for other purposes not listed in this medication guide.


Precautions

Do not use this medication if you are allergic to nortriptyline, or if you have recently had a heart attack.

Do not use nortriptyline if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take nortriptyline before the MAO inhibitor has cleared from your body.

Before taking nortriptyline, tell your doctor if you are allergic to any drugs, or if you have:

  • heart disease;
  • a history of heart attack, stroke, or seizures;
  • bipolar disorder (manic-depression);
  • schizophrenia or other mental illness;
  • diabetes (nortriptyline may raise or lower blood sugar);
  • overactive thyroid;
  • glaucoma; or
  • problems with urination.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take nortriptyline.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether nortriptyline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

Avoid drinking alcohol. It can cause dangerous side effects when taken together with nortriptyline.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by nortriptyline.

Grapefruit and grapefruit juice may interact with nortriptyline. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.

Nortriptyline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Nortriptyline can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of nortriptyline can be fatal.

Overdose symptoms may include extreme drowsiness, confusion, agitation, hallucinations, blurred vision, vomiting, muscle stiffness, feeling hot or cold, fainting, seizure (convulsions), or coma.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

  • fast, pounding, or uneven heart rate;
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • sudden numbness or weakness, especially on one side of the body;
  • sudden headache, confusion, problems with vision, speech, or balance;
  • confusion, hallucinations, or seizure (convulsions);
  • easy bruising or bleeding, unusual weakness;
  • restless muscle movements in your eyes, tongue, jaw, or neck;
  • tremors;
  • extreme thirst with headache, nausea, vomiting, and weakness;
  • feeling light-headed or fainting; or
  • urinating less than usual or not at all.

Less serious side effects may include:

  • nausea, vomiting, stomach pain, loss of appetite;
  • constipation or diarrhea;
  • weight changes;
  • dry mouth, unpleasant taste;
  • weakness, lack of coordination;
  • numbness or tingly feeling;
  • blurred vision, headache, ringing in your ears;
  • mild skin rash;
  • breast swelling (in men or women); or
  • increased sweating.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Before taking nortriptyline, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking nortriptyline, tell your doctor if you are currently using any of the following drugs:

  • cimetidine (Tagamet);
  • guanethidine (Ismelin);
  • reserpine; or
  • heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).

This list is not complete and there are many other medicines that can interact with nortriptyline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Other Names

Aventyl HCl, Pamelor, and nortriptyline

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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