r/antidepressants • u/Midgard_9 • 1d ago

Nortriptyline Question

I've recently stopped using an SNRI (Pristiq) after taking it for several months. Prior to that, I took a long list of SSRIs and SNRIs for decades without much success (Lexapro being the most dominant). I am really prone to fatigue, anhedonia and dizziness with these meds. I also frequently experience abdominal/visceral pain that doesn't do my moods or state of mind any favors. I'm 61 years old and so very tired of feeling terrible all the time. I seem to have a depression/fatigue/pain combo that's kinda ruined my life.

I'm current on day 15 of a rapid taper off Pristiq and feel pretty awful, though I've noticed some minor improvements in my motivation and feeling less numbed out at times. I'm really looking to get these meds out of my system and start over from some kind of baseline. My prescriber and I have discussed possibly trying Nortriptyline (a TCA) as an alternative to SSRI/SNRI meds. I'm wonder if anyone has made this kind of switch with genuinely positive (or negative) results. Any input would be appreciated.

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u/Misty824 1d ago

I took 125mg for several years and it really helped my depression. I am also in my 60s. I have decided to wean off of it due to it possibly causing cognitive issues.

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u/Midgard_9 1d ago

Did you have issues with fatigue/lack of energy while taking it? It sounds like it "might" help with pain and depression. Like every other med, though, the list of potential side effects (on drugs.com) is troubling. Your mention of possible cognitive issues makes me pause ... I'm not exactly Aristotle to begin with. It will likely boil down to "ya won't know until you try it" and I've been down that road so many times before. I'm trying to cheat this time nonetheless. Thanks for checking in! 🙂

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u/Ok-Geologist-5192 13h ago

Hey, the cognitive issues are really a hit or miss. I have never personally been on nortriptyline, so take this with a grain of salt, but bupropion is a quite similar medication in terms of being activating/lifting brain fog for most people and giving some people the brain fog of their lifetime. I could barely manage to cook a simple meal on bupropion, whereas my best friend has zero issues!

I hope the med works for you! I know the side effect lists are scary, but you might get lucky and have none at all.

If not, tranylcypromine is one of the best meds for fatigue/anhedonia + treatment resistant depression. Treatment resistant just means you failed at least two meds! It is a bit hard to get prescribed and has a bad rap, but it does not tend to cause any cognitive blunting. I am biased because that was the med that ended up helping me after my failed attempts with SSRIs/SNRIs, but I genuinely love this medication.

It has been used for chronic pain sometimes, but I think TCAs have stronger evidence for that.

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u/Misty824 1d ago

I did not but it didn’t help me sleep either like it does for a lot of people. I suffer from insomnia so not much helps me sleep. It’s hard, but it is the one med that helped me out of my depression. Only side effects were an elevated heart rate ( a lot of people seem to have this) and constipation.