|US brand name: Pamelor|
|Generic name: nortriptyline|
side effects, dosage, how to take & discontinue, uses, pros & cons, and more
Table of Contents (hide)
- 1. Other brand names & branded generic names1
- 2. FDA Approved Uses of Pamelor (nortriptyline HCl)
- 3. Off-Label Uses of Pamelor (nortriptyline HCl)
- 4. Pamelor’s (nortriptyline HCl) pros and cons
- 5. Side Effects
- 6. Interesting Stuff Your Doctor Probably Won’t Tell You
- 7. Pamelor’s (nortriptyline) Dosage and How to Take Pamelor (nortriptyline)
- 8. How Long Pamelor (nortriptyline HCl) Takes to Work
- 9. How to Stop Taking Pamelor (nortriptyline)
- 10. Pamelor’s (nortriptyline HCl) Half-Life & Average Time to Clear Out of Your System
- 11. Days to Reach a Steady State
- 12. Shelf life
- 13. Comments
- 14. Pamelor Ratings, Reviews, & Other Sites of Interest
- 15. References
Other Forms: Oral solution
1. Other brand names & branded generic names1
- Aventyl (US; Canada; United Kingdom; Ireland; Malaysia; South Africa)
- Allegron (Australia; Belgium; United Kingdom)
- Ateben (Argentina)
- Kareon (Argentina)
- Martimil (Spain)
- Noritren (Denmark; Finland; Italy; Japan; Norway; Sweden)
- Norline (Thailand)
- Norpress (New Zealand)
- Nortrilen (Austria; Bahrain; Belgium; Benin; Bulgaria; Burkina Faso; Cyprus; Egypt; Ethiopia; Gambia; Germany; Ghana; Greece; Guinea; Hong Kong; Iran; Iraq; Israel; Ivory Coast; Jordan; Kenya; Kuwait; Lebanon; Liberia; Libya; Lebanon; Malawi; Mali; Mauritania; Mauritius; Morocco; Netherlands; Niger; Nigeria; Oman; Qatar; Republic of Yemen; Saudi Arabia; Senegal; Seychelles; Sierra Leone; South Africa; Sudan; Switzerland; Syria; Tanzania; Thailand; Tunisia; Uganda; United Arab Emirates; Zambia; Zimbabwe)
- Nortrix (Portugal)
- Nortyline (Thailand)
- Norventyl (Canada)
- Ortrip (Thailand)
- Paxtibi (Spain)
- Sensaval (Sweden)
- Sensival (India; Japan)
- Vividyl (Italy)
Depression. The odds favor relief for endogenous depression - i.e. being depressed for no good reason.
3. Off-Label Uses of Pamelor (nortriptyline HCl)
- Dysthymia (constant, mild depression).
- Panic & Anxiety disorders.
- Smoking cessation. Not as good as Wellbutrin, but if other meds don’t work and/or suck too much, and you’re highly motivated to quit, nortriptyline is a lot better than nothing.
- All sorts of neuropathic and chronic pain issues, including:
- Chronic tinnitus and the depression often associated with chronic tinnitus.
- Somatoform pain disorder (where they think it’s all in your head).
- Vulvodynia. If you’re so depressed that your girlie bathroom parts hurt, or because your girlie bathroom parts hurt you’re really depressed, not only do they have a word for it but nortriptyline is prescribed for it.
Nortriptyline has been around since forever, so doctors are familiar with its uses and effects. It’s apparently less likely to mess with your heart than other TCAs.
Nortriptyline has been since forever, so younger doctors are less likely to prescribe it and other TCAs, even if they might be a better first or second choice for you. Regular blood tests are advised for dosages above 100mg a day - which is right about where most people can expect the therapeutic dosage to be.
The anticholinergic side effects typical when starting TCAs - headache, nausea, sweating, dry mouth, sleepiness or insomnia, constipation, urinary hesitancy, and blurry vision. If you get any, or all of these, expect them to pass in a week or two. Maybe. Weight gain is also common and may or may not go away. Sedation, constipation, dry mouth, and urinary hesitancy are the most likely to stick around.
Heart palpitations (although nortriptyline has a lower rate of serious cardiac problems), no libido and other sexual dysfunctions. Nightmares.
Intense nightmares. Demonic possession. I don’t know if the two are related.
Nortriptyline is one of the active metabolites of amitriptyline, so Pamelor is to Elavil as Tofranil (imipramine) is to Norpramin (desipramine).
Nortriptyline is extensively metabolized by your liver’s CYP2D6 enzymes. If you’re a poor metabolizer you’ll probably need a hell of a lot less than the standard dosage.
By the book they’d start you off at 25mg three to four times a day. Or maybe all 75–100mg at once at bedtime. The thing is, once you start taking more than 100mg a day you need you need regular blood work. Yet the med isn’t rated as safe above 150mg a day. Wha-a-a-a? I’d start you out at 25mg a day and see how you go from there, and not bother with this med if it doesn’t do something for you by the time you reach 100mg a day.
TCAs generally take 14 to 28 days to kick in.
Unless you need to stop taking Pamelor (nortriptyline) for something like a severe allergic reaction or something equally bad, your doctor should be recommending that you reduce your dosage by 25–50mg a day every five to seven days if you need to discontinue. TCA’s don’t have a discontinuation syndrome like SSRIs do, but it can be really unpleasant to stop taking any crazy med too quickly.
There’s nothing in the PI sheet, and I’ve found independent sources giving ranges of 16–90 hours. So that’s anywhere from 3 to 19 days, but let’s call it a week.
None is published. And the half-life is too variable to really pin it down.
Tablets: 3 years.
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Give your overall impression of Pamelor on a scale of 0 to 5. Detailed ratings and reviews are available on the Pamelor Ratings & Reviews Page.
Get all critical about Pamelor
Rating 3.1 out of 5 from 54 criticisms.
Vote Distribution: 9 – 3 – 4 – 8 – 19 – 11
If you’re still feeling judgmental as well as just mental2, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
Get all judgmental about the Pamelor (nortriptyline) Synopsis
Rates 3.8 out of 5 from 39 value judgments.
Vote Distribution: 3 – 1 – 2 – 3 – 16 – 14
Medicine Is The Best Medicine
I <3 Wellbutrin
14.3 Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, check for drug-drug interactions
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
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PDR: Physicians’ Desk Reference 2010 64th edition
Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton
The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.
Healing Anxiety & Depression Daniel G. Amen, M.D., and Lisa C. Routh, M.D. © 2003. Published by G.P. Putnam’s Sons.
Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier.1 The term "branded generic" has three meanings:
1) A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version. E.g. Greenstone Pharmaceuticals makes gabapentin, and they are owned by Pfizer, who also own Parke-Davis, the makers of Neurontin.
2) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Teva's Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
3) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Sanofi-Aventis' Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride). We aren't sure if that really makes a difference or not. The FDA says they're the same thing. As usual, the data are contradictory, but most evidence indicates that the FDA is right and the differences are negligible.
For our purposes a "branded generic name" refers to the second and third definitions.
2 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
If you have any questions not answered here, please see the Crazymeds Pamelor discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)
|Last modified on Monday, 24 February, 2014 at 18:18:26 by SomeMedCritic||Page Author Jerod Poore||Date created|
|“Pamelor (nortriptyline): a Synopsis for the Educated Consumer.” by Jerod Poore is copyright © Jerod Poore||Published online 2011/03/22|
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Pamelor, and all other drug names on this page and used throughout the site, are a trademark of someone else. Pamelor’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.