side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
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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. Bibliography
|US brand name: Pamelor|
|Generic name: nortriptyline|
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.
- 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.
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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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Get all critical about Pamelor
Rating 3.0 out of 5 from 17 criticisms.
Vote Distribution: 2 – 2 – 2 – 2 – 6 – 3
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
Rating 3.6 out of 5 from 16 value judgments.
Vote Distribution: 2 – 0 – 1 – 0 – 9 – 4
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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If you have any questions not answered here, please see the Crazymeds Pamelor discussion board.
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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. I 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 I write these damn things. I’m frustrated enough as it is. 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.
|Last modified on Monday, 24 February, 2014 at 18:18:26 by SomeMedCritic||Page Author: JerodPoore||Date created Tuesday, 22 March, 2011 at 13:26:30|
Pamelor, and all other drug names on this page and use throughout the site, are a trademark of someone else. Look on the the PI sheet 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.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
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All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
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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?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]