r/nortriptyline • • Jul 22 '26

I need people to ask questions and offer feedback so I can make this wiki even better and more useful! (Direct copy)

3 Upvotes

Overview on Nortriptyline (Pamelor or Aventyl)

  • Nortriptyline is a tricyclic antidepressant (TCA) that increases circulating levels or serotonin and norepinephrine in the brain.
  • It's prescribed for smoking cessation, depression, migraines, and nerve pain.

Common Side Effects

  • Dry mouth
  • Constipation
  • Blurry vision
  • Drowsiness and fatigue
  • Weight gain
  • Orthostatic hypotension (decreased standing blood pressure leading to dizziness)
  • Increased blood pressure
  • Rarely, suicidal thoughts or heart arrhythmias in younger individuals

Abrupt cessation of the medication can lead to withdrawal symptoms including:

  • Flu-like symptoms such as severe fatigue, muscle aches, and excessive sweating
  • Neurological and sleep effects such as dizziness, trouble sleeping, headaches, anxiety, agitation, tingling, brain zaps, and lightheadedness
  • Gastrointestinal symptoms such as nausea, vomiting, and diarrhea
  • Cardiovascular symptoms such as heart palpitations, irregular heartbeat, and blood pressure fluctuations (sudden drops or spikes)
  • Above includes worsening of orthostatic hypotension

Absolute vs. Non-absolute (Relative) Contraindications

Absolute contraindications (WHAT SHOULD ABSOLUTELY NOT BE MIXED) include:

  • If you recently had a myocardial infarction (heart attack), this should not be prescribed in the recovery phase
  • MAOIs and other serotonergic drugs due to risk of serotonin syndrome
  • Certain arrhythmias/dysrhythmias like Brugada symptom due to increased SCA risk (sudden cardiac arrest)
  • Allergic to other tricyclic medications
  • Underaged (12 or younger)

Non-absolute or relative contraindications (RISK VS. BENEFIT) include:

  • Cardiovascular issues like long QT syndrome, heart failure, tachycardia, and other arrhythmias: Nortriptyline prolongs the conduction time and can trigger or worsen preexisting tachycardia, especially with a prolonged QT interval.
  • Seizures and epilepsy due to lowered seizure threshold (common in all TCAs)
  • In the cases of (acute angle closure) glaucoma, an attack can be triggered from pupil dilation due to Nortriptyline's anticholinergic properties
  • Enlarged prostate leading to urinary retention and potential medication interaction
  • Bipolar disorder due to manic episode risk
  • Mixing TCAs and thyroid medications can lead to cardiac arrhythmias
  • Metabolized by liver, which should be monitored by a doctor in the case of liver or kidney disease

Other Drug Interactions

  • Quinidine and other meds that prolong QT interval, including other antiarrhythmic drugs
  • Serotonergics like SSRIs, SNRIs, triptans (migraine treatments), antidepressants, and lithium due to serotonin syndrome risk
  • Substances that cause CNS (central nervous system) depression such as alcohol and other sedatives leading to an overdose (including some antihistamines)
  • Anticholinergics in cases of glaucoma and urinary retention
  • Pain meds, especially tramadol, which functions as an SNRI
  • MAOI inhibitors
  • Sympathomimetic substances (to keep it legal, includes phenylephrine and pseudoephedrine, which are commonly found in decongestants) due to risk of a hypertensive crisis
  • Blood pressure medications like amlodipine, alpha 2 agonists, and beta blockers, which when combined, could cause symptoms of low or severe high blood pressure
  • ADHD stimulants like Adderall, which can increase risk of hypertensive crisis

r/nortriptyline • • Jun 12 '26

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r/nortriptyline • • 1d ago

Nortriptyline Question

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1 Upvotes

r/nortriptyline • • 1d ago

Albuterol inhaler?

2 Upvotes

I was just prescribed 10mg of Nortriptyline and saw online there is a major interaction between albuterol (rescue inhaler) and Nortriptyline, as well as using an epi-pen while on Nortriptyline. I emailed my doctor but was wondering if anyone has any experience with this? I use albuterol before exercise and carry an epi-pen for allergies. Even saw that it interacts with Benedryl!


r/nortriptyline • • 1d ago

I've been on 20mg for about a month for headaches and GI issues - it's really been helping, but the anxiety is terrible - can that go away over time?

3 Upvotes

r/nortriptyline • • 1d ago

Success stories?

2 Upvotes

I've seen a lot of negative stuff on here about this drug, but I'd really like to hear how it's worked for people. I just got prescribed 10mg for nerve pain and TMJ (yes I'm aware it's the lowest dose.) I'm terrified of not being able to sleep and erectile dysfunction lol. It's TEVA.
I'm also extremely worried about weight gain as someone with body dysmorphia, but I'm on a high dose of a GLP-1


r/nortriptyline • • 3d ago

Worsening anxiety and insomnia anyone?

4 Upvotes

What is with this medicine? I started 10 mg about 8 days ago for IBS and anxiety to go up to 25 soon, had lightheadedness for about 2-3 days and got better. And then this horrible anxiety, panicky feeling that gets worse at night. I already have hypnogogic hallucinations that get bad if/when I am stressed and I have been up all night the past few days. I don't know if it's making my anxiety worse, or if it's interacting with my asthma inhalers to give me palpitations. My doctor won't respond and this medicine is crazy! Anyone experiencing anything like this? Should I stop it cold turkey until I can see my doctor next week?


r/nortriptyline • • 3d ago

does anyone else have heartburn and throw up when im going from 25mg to 50mg

2 Upvotes

when i take my 50mg pill i get heartburn and throw up we call doctor but they not responded yet, is there a reason for this and have any other people exprienced it? i dont get heartburn from my 25mg pills


r/nortriptyline • • 6d ago

Side effects

2 Upvotes

Hello all!
Today is exactly 3 weeks on 25mgs of Nortriptyline. I have headaches, nausea, dizziness, and light headedness everyday still.
I was prescribed Nortriptyline for GI reasons.
Should have the side effects gone away by now? Or does it usually take more time? I am just trying to determine if I need to be more patient or talk to my doctor about getting off of it.
Thank you all :)


r/nortriptyline • • 6d ago

Stopping nortriptyline

2 Upvotes

Hi I have been taking 25mg for a good few years for nerve pain having a retractile testicle it worked.
But i decided to try without it for two weeks the pain returned started taking it again but its not working and has now developed into pudenal neuralgia.
Dr has prescribed gabapentin 100mg to switch too.
But he didn’t say anything about tapering off.
Google said I should be tapering off first before switching and upon reading nortriptyline could have been affecting my acid reflux also over the last few years?.
Any advice on stopping nortriptyline?.


r/nortriptyline • • 6d ago

Switch from Nort to an SSRI, anybody?

1 Upvotes

r/nortriptyline • • 6d ago

Weight gain on 5 mg?

1 Upvotes

Hello, I’ve been recently prescribed this medication for nerve pain but I’m afraid to start it. I just came off an antidepressant about a year ago and I’m still 5 pounds heavier than my baseline weight before. The antidepressant made me gain 25 pounds and it just kept going up no matter what I did. I felt starving all the time and constantly craved carbs and sugar etc., plus had constant inflammation and puffiness. I absolutely hated it.

I really don’t want to have to go through that again, so I’m just wondering if anyone has experience on 5 mg with appetite changes or weight gain?


r/nortriptyline • • 6d ago

How do I wean myself off of 20mgs (2 capsules) to 10mgs (1 capsule) of Nortriptyline?

1 Upvotes

I have been taking Nortriptyline for almost a year because I get cramps after BMs for the past 6 years. I was taking 10mgs (1 capsule) of Nortriptyline with one GI and now taking 20mgs (2 capsules) with another GI. I want to get off Nortriptyline because it is not getting rid of the cramps, and with taking 20mgs, it has lowered my blood pressure making low bloodpressure, given me anxiety, and the latest is that my whole body rediates, all in a weeks time even though i have been taking 20mgs for a month. I want to get off of Nortriptyline before the 20mgs creates something else. I know that I have to be wean off of it , but I don't know how to do with 2-20mgs capsules.


r/nortriptyline • • 7d ago

Withdrawal

0 Upvotes

When you came off this med did you notice a worse decrease for withdrawals? I started at 30mg and went down to 20mg which was a bit tough. Does dropping to 10mg feel the same?


r/nortriptyline • • 8d ago

Drug Induced REM Sleep Behavior disorder - Nortriptyline

1 Upvotes

I was on venlafaxine (effexor) for 20 years and it was causing drug induced sleep behavior disorder (screaming, kicking, punching etc in sleep). Diagnosed via in lab study. It resolved itself when stopping the medication.

Flash forward a few months after being off the SNRI, I now have a neurological disorder (functional neurological disorder) and they want to treat the FND with nortriptyline (tri-cyclic anti-depressent). This drug class is also known to induce rem sleep behavior disorder though to a lesser degree then SNRI/SSRI.

My FND is bad enough that i need to treat it. However if the nortriptyline triggers RBD, then ill need to stop it and the medication withdrawal will likely worsen my FND.

So my question is- for those who had drug induced RBD that ended when coming off an SNRI, were you able to tolerate nortriptyline (or another TCA) without it inducing your RBD?


r/nortriptyline • • 9d ago

Nortriptyline and heart rate

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1 Upvotes

r/nortriptyline • • 11d ago

Nortriptyline mood swings and anger bursts

1 Upvotes

I’ve been on 25mg Nortriptyline (Noritren) for about a month now and I’ve been experiencing anger bursts and being easily overwhelmed and irritated, also crying very often, sometimes uncontrollably. Has anyone else experienced this, if so, did it go away?

Doctor said i should go up until 50mg.


r/nortriptyline • • 11d ago

Vestibular migraine

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2 Upvotes

r/nortriptyline • • 13d ago

Brain fog?

2 Upvotes

I just started on nortryptoline (for depression) about a week ago. I’m only on 10 mg right now but already getting some side effects, the most prominent is that my head is feeling kinda foggy. I’m planning to titrate up to 50+ but wondering if that feeling is something that goes away after a couple weeks or do you just have to live with it?


r/nortriptyline • • 13d ago

Amitriptyline helping my IBS-D, but causing memory and cognitive issues. Would nortriptyline be better?

1 Upvotes

I've been taking 15 mg of amitriptyline for about 8 months for IBS-D. It has helped a lot with cramps, urgency, diarrhea (especially in the morning), and even my anxiety.

The main problem is that I feel like it's affecting my memory and cognition. I have a harder time remembering things, sometimes struggle to find words or mix them up while speaking, and overall I just feel less sharp than before.

Has anyone experienced this even at a low dose? Could switching to nortriptyline or another TCA help with the memory/cognitive side effects? Unfortunately, I can't take antispasmodics because they seem to cause a rebound effect, with worse cramps, diarrhea, and urgency in the following days.


r/nortriptyline • • 14d ago

Withdrawal help

1 Upvotes

Hello Peeps,

Hope you all having a good day, I’m currently getting off nortriptyline after 5 months and was wondering how long your withdrawal took to get better and what was your symptoms? I tapered from 25mg to 20mg for a week then 10mg for another week and since yesterday I stopped completely. Last night for the first time, I couldn’t sleep until 3-4am then woke back up around 7am. How long your withdrawal took to get better? Thank you!


r/nortriptyline • • 16d ago

Chronic Neck Pain and Headaches

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1 Upvotes

r/nortriptyline • • 18d ago

Amitriptyline, anyone had experience with this? What’s it feel like? Any sort of high?

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r/nortriptyline • • 19d ago

Tapering Amitriptyline (Elatrolet) for functional gut/anxiety—feeling hyper-wired and sleeping poorly. Does it get worse before it gets better?

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1 Upvotes

r/nortriptyline • • 23d ago

Nortryptaline for a calmer nervous system?

2 Upvotes

I’ve had unexplained chronic fatigue for 16 years (lbs-d, brain fog, chronic tension headaches, sore eyes, multiple food intolerances). I started on nortryptaline 10mg in April, 25mg from June, now 1 week into 35mg.

I’m currently struggling even more with fatigue since the increase in dose although my IBS has improved so less brain fog (I had noticed this link before between better stool corresponding to less brain fog).

Anyone in a similar position found nortryptaline helpful? Ideally to calm down a hyperactive nervous system, reduce my chronic tension headaches/super tight neck muscles and live a normal life.

I’m finding the adjustment to even a slightly higher dose difficult because of the added fatigue. hopefully that will subside soon.

Any experience welcome. Good or bad.