Nortriptyline is part of the family of medications known as tricyclic antidepressants, and it has a variety of applications ranging from treating mood disorders to treating chronic pain and juvenile bedwetting. Doctors sometimes use this medication to relieve headache pain, and to treat fatigue disorders. The full name of the drug that is conventionally marketed is nortriptyline hydrochloride (HCl), and it refers to the medication's hydrochloride salt form, which keeps the compound stable.
Structurally, nortriptyline hydrochloride resembles other tricyclic antidepressants, particularly amitriptyline. This drug exhibits functional actions similar to its relatives, as well. It reduces the breakdown of certain chemicals in the brain, known as norepinephrine and serotonin, that are involved in the regulation of mood. Preventing the breakdown of these chemicals allows brain cells to utilize them for longer periods of time, which accounts for many of the effects of nortriptyline HCl.
Certain everyday behaviors can be risky for patients taking nortriptyline hydrochloride. It may initially cause changes in thinking, so potentially dangerous tasks requiring concentration, such as driving, should be avoided until the individual effects are known. Sensitivity to light can be a feature of nortriptyline, so patients taking this drug often wear sunscreen before spending time outside. Patients may have to consult a doctor before drinking grapefruit juice, because certain compounds found in this fruit may boost the duration or strength of an antidepressant dose. Alcohol is also usually avoided on the grounds that it may lead to hazardous side-effects.
Just as with any antidepressant, nortriptyline hydrochloride can cause certain side effects. Headaches, nausea, and upset stomach are common effects, although most individuals quickly gain a tolerance to them. More serious are side effects like confusion, numbness of the limbs, difficulty breathing, or extreme changes in heart rate. Any of these effects can indicate the presence of a serious medical condition, and should be cause for seeking immediate medical assistance.
Patients taking this drug should be aware of potential nortriptyline hydrochloride drug interactions. Doctors must know about all other prescription and over-the-counter medications a person takes before advising that they use nortriptyline HCl, to avoid unpleasant or dangerous interactions. Antacid medications such as cimetidine can increase levels of this medication in a similar manner to grapefruit juice, leading to potential overdose conditions. Recent usage of other types of antidepressants, herbal supplements, and heart medications may also create problematic side effects.