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