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NortriptylineAka: Aventyl, Pamelor

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  1. Background
    1. Cost: $60 per month
  2. Dosing: Depression
    1. Start at 25mg PO qhs for 3 days
    2. Next: 50 mg PO qhs for 3 days
    3. Therapeutic Dose: 75 mg PO qhs
  3. Pharmacokinetics
    1. Not effective at low dose
    2. Therapeutic serum level: 50 to 150 ng/ml
    3. Serum Half Life: 36 hours
    4. Narrow therapeutic window
      1. Always obtain a serum level after 75 mg for 7 days
  4. Adverse effects
    1. See Tricyclic Antidepressants
    2. Much less adverse effects than tertiary amines
    3. Moderate adverse effects
      1. Sedation
      2. Cardiac arrhythmia
  5. Precautions
    1. See Tricyclic Antidepressants
    2. Serious cardiotoxicity in overdosage
  6. Advantages
    1. Good nighttime sleep without daytime grogginess
    2. Inexpensive (generic)

Nortriptyline (C0028420)

Definition (MSH)A metabolite of AMITRIPTYLINE that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions.
Definition (CSP)tricyclic antidepressant of the dibenzocycloheptadiene class used to treat symptoms of depression and to relieve chronic, severe pain.
Definition (NCI)A tricyclic antidepressant agent used for short-term treatment of various forms of depression. Nortriptyline blocks the norepinephrine presynaptic receptors, thereby blocking the reuptake of this neurotransmitter and raising the concentration in the synaptic cleft in the CNS. Nortriptyline also binds to alpha-adrenergic, histaminergic and cholinergic receptors. Long-term treatment with nortriptyline produces a downregulation of adrenergic receptors due to the increased stimulation of these receptors.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD009661
EnglishDesitriptyline, Desmethylamitriptylin, Nortriptyline, NORTRIPTYLINE PREPARATION, Nortryptyline, NTPL
Spanishnortriptilina
Parent ConceptsDibenzocycloheptenes (C0012032), Antidepressive Agents, Tricyclic (C0003290), cycloheptane (C0178579), Antidepressive Agents (C0003289), Duplicate concept (C1274013)
SourcesAOD, CSP, LNC, MSH, MTH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Pamelor (C0030256)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD009661
EnglishMallinckrodt Brand of Nortriptyline Hydrochloride, Pamelor
SourcesMSH, MTH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Aventyl (C0528314)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD009661
EnglishAllegron, Aventyl, Dista Brand of Nortriptyline Hydrochloride, Lilly Brand of Nortriptyline Hydrochloride, Paxtibi
SourcesMSH, MTH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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