I'm not sure if this is the right place to post, but I can't find anything about this med elsewhere on the boards. I've just started nortriptyline (I know it's also called Pamelor) today after a few unsuccessful rounds with ssris. My doctor figured this med would be better for me, as I suffer from migraines as well as depression. I'm starting at a low dose (25mg) and will build up to 50 and then take it from there.

I really hope this med helps. My life is total hell, and the prozac and lexapro just were not on for me.

Fingers crossed.

Hi sadinsomniac,

It is the right place to post so don't worry. I guess maybe not that many people take this which is why people have been slow to respond. I did a search of older posts and found a thread about it at http://www.depressionforums.org/forums/Nor...l=nortriptyline that you may want to look at. If you search there are also a few more shorter threads about it.
Hope this helps a little. Good luck!

PRT xx

Thanks for finding this and posting it PRT!

Glad to see at least some people have tried it. My doc said that yes, tricyclics can cause more weight gain (which is a worry because I have inflamed joints, and weight gain makes walking hard). But he said that this one causes less weight gain than the "first generation" tricyclics.

He said that ssri's aren't for everyone, and this one should settle me down more than the prozac and lexapro, and is also better as a migraine preventative.

Hey,

No problem. I hope it works out for you.
I'm on an SSRI and it's making me gain weight at a pretty quick pace.

If you bump this thread from time to time, you might find someone comes along with some recent experience.

PRT xx

Bumping the thread. I'm on 25mg, and will be going up to 50 later this week. So far, all I'm experiencing is a dry mouth. Fortunately this med doesn't seem to be ******* my sleep cycle like prozac and cipralex did. And none of the wacky nausea/headaches/dizziness that I got from cipralex either.
Fingers crossed that it will help my depression and anxiety...

Pamelor/Allegron ( Nortriptyline) is a Secondary Amine of Tricyclic Antidepressant group. It is actually an active metabolite from Elavil/Endep ( Amitriptyline), which is a Tertiary Amine.

Tertiary Amine Amitriptyline blocks the re-uptake of Serotonin and Noradrenaline. Its active metabolite is Nortriptyline, which predominantly blocks the re-uptake of Noradrenaline, and being a secondary amine, Nortriptyline has a lesser sedation and anticholinergic ( dry mouth) effect, than Amitriptyline.

SSRI's like Prozac, Zoloft only blocks the re-uptake of Serotonin, however, as it also affects 5-HTP( Serotonin) subtypes 2 and 3, therefore it causes side effects like nausea, anxiety,restlesness etc.

There is another antidepressant that works more specifically for migraine and tension headache, REMERON ( Mirtazapine), which affect 5-HTP(Serotonin) subtype 1 and Noradrenaline by releasing them from the synaptic cells, as well as blocking 5-HTP (Serotonin) subtype 2 and 3, therefore it does not cause anxiety,jitteriness, insomnia nor nausea. REMERON is classified as NaSSA not SSRI (Prozac, Zoloft) nor SNRI (Effexor, Cymbalta).

In small dose, REMERON is sedating as it affect Histamine-1 receptor, however, in larger doses, it can affect some opioid receptors too( mu and kappa-3), therefore in large doses it is very useful for chronic tension headache and pain. EFFEXOR also affects some opioid receptors too in larger doses above 150mg, but being an SNRI, it can cause nausea, rise in blood pressure, anxiety, insomnia and jitteriness.

If, Nortriptyline is bothering so much with its anticholinergic effect ( Dry mouth etc.), another option can be REMERON, which is relatively free from anticholinergic effect and have some pain relieving activity as well as non-cardiotoxic ( does not cause irregular heart beat).

Well, the good news is the med seems to be working at least a bit. It's only been a short time, and my sleep cycle has improved significantly. I'm also a lot less anxious. The depression is still holding, but it's nice being able to sleep at night, and have less of the crippling anxiety.

Compared to my reaction to the ssri's I'll happily live with the dry mouth and mild sedation. The sedation actually makes a very stressful home environment more tolerable. Hope this keeps up...

Hi, I'm just about to start taking nortriptyline. I'm coming off fluoxetine due to lack of appetite, sleep problems, anxiety and tremors. I have to spend a week flushing the fluoxetine then I can start taking the nortriptyline.
I've love to hear how other people are getting on as I'm really nervous about the side effects as I had such a rough time with the SSRI.

Hi sadinsomniac,

TriCyc ADs and not used as the first line drugs for depression, Docs like to use SSRI/SNRIs first. As you have tried two SSRIs I suppose giving Nortriptyline a go is the next logical step.

The older meds like Nortriptyline were all the rage in the 7o's, but due to the 'heavy' side effects and tendency to sedation/overdose they fell out of favour when Prozac hit the market in the 80s. the wonder SSRI med!

I hope you find it effective, it is a well establishes tried and tested drug and my wife found it effective for a physical problem as well - most AD are used for many conditions!

Best of Luck with your third med and I hope you find it successful.

Best Wishes

Jum Bow

Thought I'd comment, as the non-sedating TCAs seem pretty rarely prescribed these days.

Just started Nortriptyline last Friday at 25mg; will titrate up from 50mg to 75mg tonight. Haven't really noticed much sedative effect. My sleep has been disrupted by a number of other factors (coming off Lexapro and lingering Abilify[awful drug for me!]), so I wouldn't (yet) blame the Nortrip, either. AD effect is minimal, if any, right now. Really hoping this will work; otherwise, I'd need some months off of work for washout and waiting for an MAOI (Parnate, probably) to start working.

I'm also on Selegiline, 4mg daily, for RLS (it's only MAO-B inhibiting at this dose). The TCA/Selegiline combo is apparently popular with the depressed Parkinson's crowd.