Nortriptyline: The Tricyclic Antidepressant for Depression and Neuropathic Pain
What is Nortriptyline?
Nortriptyline (an active metabolite of amitriptyline) is a tricyclic antidepressant (TCA) used primarily for the treatment of depression. It is also used to treat neuropathic pain and chronic pain conditions. Nortriptyline increases the synaptic concentration of serotonin and norepinephrine in the brain, which elevates mood and reduces pain.
How Nortriptyline Works
Nortriptyline inhibits the reuptake of serotonin and norepinephrine from the synapses enhancing their action for a longer duration in the brain. It also has analgesic properties, which make it effective for pain management in conditions like fibromyalgia and diabetic neuropathy.
When to Use Nortriptyline
● Depression: Nortriptyline is used to treat major depressive disorder (MDD).
● Neuropathic Pain: It is used to manage nerve-related pain, including postherpetic neuralgia and diabetic neuropathy.
Dosage
● Adult Dose for Depression: Typically, 25 mg to 50 mg daily, taken at bedtime. Maximum dose is 150 mg/day.
● Adult Dose for Neuropathic Pain: 25 mg once daily, with adjustments based on response. Maximum dose is 150 mg/day.
● Pediatric dosage : For ADHD, the starting dose is 0.5 mg/kg/day. Maximum dose is 2 mg/kg/day.
Side Effects
● Common Effects: Dry mouth, drowsiness, blurred vision, and constipation.
● Serious Adverse Effects: Cardiac arrhythmias, weight gain, and orthostatic hypotension.
Common Indian brands: Primox, Nortimer
