When your doctor prescribed you a medicine called Nortriptyline, you might feel a little scared and confused. It's normal for many of us to think that way when we hear "a medicine for the brain," "a medicine for a mental illness." But don't worry. This is just like any other medicine for our body. Okay, let's explain everything about this medicine very simply, as if we were talking to a friend.
What is this medicine called Nortriptyline?
Simply put, Nortriptyline is a medication used to treat depression . It belongs to a class of medications called tricyclic antidepressants (TCAs) .
Think of it this way: our brains have chemicals that act like little messengers. We call these neurotransmitters . These messengers play a big role in controlling our mood, feelings like happiness and sadness. Serotonin and norepinephrine are two of the main messengers. People with depression may have an imbalance of these chemicals in their brains. Nortriptyline works by restoring that balance and helping to improve your mood.
Sometimes doctors use this medicine for other medical conditions, so if you have any questions, ask your doctor about it.
Things you need to tell your doctor before starting this medication
This is very important. To treat you safely, your doctor needs to know your complete health history. If you have any of the conditions listed below, be sure to tell your doctor before starting Nortriptyline.
| Disease or condition | Why is it important to inform the doctor? |
|---|---|
| Conditions such as heart disease or Brugada syndrome | This medicine can sometimes affect heart rate. |
| Mental illnesses such as bipolar disorder or schizophrenia | The effects of the medication may vary, and symptoms may worsen. |
| Liver disease | Liver function is important because the liver helps remove medications from the body. |
| Glaucoma or difficulty urinating | This medicine may worsen those conditions. |
| Seizures | The medicine may slightly increase the risk of seizures. |
| Thyroid disease | There may be an interaction between thyroid hormones and this medication. |
| Alcohol drinking habit | Taking alcohol and this medication together may increase drowsiness and other side effects. |
| Suicidal thoughts or previous attempts | This is very important. The doctor should be aware of this. |
| Being pregnant, trying to get pregnant, or breastfeeding | You should discuss the possible effects on the baby with your doctor. |
| Allergies to other medicines, foods or substances | You should inform your doctor if you are allergic to nortriptyline or other TCA medications. |
How should I use this medicine?
- Take this medicine with a glass of water. Take it exactly as prescribed by your doctor, at the right time.
- Please remember not to take a double dose .
- Most importantly: Do not stop taking this medication suddenly without your doctor's advice. Doing so may worsen your condition and cause side effects such as headaches and nausea. If you stop taking the medication, do so gradually and only as directed by your doctor.
Warning: Overdose
If you think you have taken too much of this medicine, contact the National Poisons Information Centre at the National Hospital immediately. Or go to the Emergency Department (ETU) at the nearest hospital. This medicine is for you only. Never share it with anyone else.
What to do if you miss a dose of medication?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at the same time.
Other things that can cause problems with this medicine (Interactions)
Nortriptyline is a medication that can cause problems (interactions) with other medications. Therefore, it is very important to tell your doctor about all the medications you are taking, including Sinhala medicines, Ayurvedic medicines, vitamins, and supplements that you take from your family doctor.
Do not take this medicine with anything!
If you are taking the following medications, taking Nortriptyline is strictly prohibited .
- Cisapride
- Dronedarone
- Linezolid
- Pimozide
- Thioridazine
- Medications in the class of drugs called MAOIs (e.g. Carbex, Marplan)
- Methylene blue (intravenous)
There can be problems with these medications too.
The following medications may also interact with Nortriptyline. So if you are taking any of these, tell your doctor.
- Alcohol
- Some medicines for allergies, coughs, and colds (Antihistamines)
- Other antidepressants (e.g. fluoxetine, sertraline)
- Medications that affect heart rate (QT interval prolonging drugs)
- Painkillers (e.g. tramadol)
- Medicines like Cimetidine, Quinidine, Reserpine
- Thyroid hormones
Things to keep in mind when taking medication
Be aware of changes in mood.
This is very important. Especially in the first few weeks of taking this medicine or after changing the dose, you and your family should be vigilant for new or worsening feelings of anxiety, restlessness, irritability, insomnia, or suicidal thoughts. If you notice any of these changes, talk to your doctor right away.
Drowsiness and dizziness
This medicine may make you feel drowsy or dizzy. Therefore, do not drive or operate machinery until you know how this medicine affects you. Especially if you are elderly, do not get up suddenly from a sitting position. Stand up slowly after a while. This will reduce the risk of dizziness and falling.
Other common problems and their solutions
- Dry mouth: Chewing sugar-free gum and drinking plenty of water can help.
- Dry eyes and blurred vision: Contact lenses can be uncomfortable. Lubricating drops can be used. If this problem persists, see an eye doctor.
- Constipation: Try to have a bowel movement at least once every two to three days. Eat more fiber-rich foods, vegetables, and fruits. If you don't have a bowel movement after 3 days, tell your doctor.
- Sun sensitivity: Your skin may be more likely to burn when taking this medication. Therefore, if you are going to be in the sun, wear clothing that covers your body and use sunscreen.
Side effects of the medicine
Like any medication, Nortriptyline can cause side effects. Some of these are dangerous, while others are common.
| Side effect | Description |
|---|---|
| Serious side effects that should be reported to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Changes in heart rate | Fast or irregular heartbeat, dizziness, chest pain, difficulty breathing. |
| Serotonin syndrome | Restlessness, confusion, excessive sweating, fever, muscle stiffness or tremors, vomiting, diarrhea. |
| Seizures | Sudden onset of seizures. |
| Sudden pain or changes in appearance in the eyes | Blurred vision, seeing rings around lights, eye pain. |
| Difficulty urinating | Difficulty urinating or no urine output. |
| Side effects that are usually not dangerous, but should be reported to the doctor if they persist | |
| Drowsiness or dizziness | These will decrease as the body gets used to the medication. |
| Dry mouth | It can be controlled by drinking more water. |
| Constipation | It can be controlled by eating more fiber-rich foods and drinking more water. |
| Changes in sexual desire or function | Talk openly with your doctor about this. |
How do you keep your medicine safe?
Keep this medicine out of the reach of children . Store at room temperature, away from sunlight, in a tightly closed container. Throw away expired medicine.
Take-Home Message
- Nortriptyline is a medication used to treat depression. It helps balance brain chemicals and improve mood.
- Avoid stopping the medication suddenly without medical advice.
- Tell your doctor about all other medications you are taking (including over-the-counter medications) and any medical conditions you have.
- During the initial period of treatment, you and your family should be aware of your mental state (especially suicidal thoughts). If you notice any changes, inform your doctor immediately.
- Common side effects such as drowsiness and dry mouth may occur, and if you experience severe side effects (changes in heart rate, allergies), seek medical advice immediately.
- If you have any concerns about this medication, never be afraid to discuss it with your doctor.
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