Nortriptyline
Nortriptyline, sold under the brand name Pamelor, among others, is a medication used to treat depression. This medicine is also sometimes used for neuropathic pain, attention deficit hyperactivity disorder (ADHD), smoking cessation and anxiety. As with many antidepressants, its use for young people with depression and other psychiatric disorders may be limited due to increased suicidality in the 18–24 population initiating treatment. Nortriptyline is a less preferred treatment for ADHD and stopping smoking. It is taken by mouth.
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| Trade names | Pamelor, Noritren, Nortrilen, others |
| Other names | Desitriptyline; ELF-101; E.L.F. 101; N-7048 |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a682620 |
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| Routes of administration | By mouth |
| Drug class | Tricyclic antidepressant (TCA) |
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| Pharmacokinetic data | |
| Bioavailability | 32–79% |
| Protein binding | 92% |
| Metabolism | Liver |
| Metabolites | 10-E-Hydroxynortriptyline |
| Elimination half-life | 18–44 hours (mean 30 hours) |
| Excretion | Urine: 40% Feces: minor |
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| ECHA InfoCard | 100.000.717 |
| Chemical and physical data | |
| Formula | C19H21N |
| Molar mass | 263.384 g·mol−1 |
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Common side effects include dry mouth, constipation, blurry vision, sleepiness, low blood pressure with standing, and weakness. Serious side effects may include seizures, an increased risk of suicide in those less than 25 years of age, urinary retention, glaucoma, mania, and a number of heart issues. Nortriptyline may cause problems if taken during pregnancy. Use during breastfeeding appears to be relatively safe. It is a tricyclic antidepressant (TCA) and is believed to work by altering levels of serotonin and norepinephrine.
Nortriptyline was approved for medical use in the United States in 1964. It is available as a generic medication. In 2021, it was the 139th most commonly prescribed medication in the United States, with more than 4 million prescriptions.