Nortriptyline belongs to the tricyclic antidepressants and their chemical structure similar to amitriptyline. However, compared with the latter, Nortriptyline has mild stimulant, as well as improve mood effect. Nortriptyline provides the most minimal sedation. Nortriptyline successfully fights hypochondriacal states. The antidepressant effect of the drug occurs rapidly (within two weeks of receipt).
The nosological classification (ICD-10)
Nortriptyline (Nortriptylin) — description of the preparation: composition and instructions for use, contraindications, indications for use of the drug nortriptyline
F32 Depressive episode
F33 Recurrent depressive disorder
F50.2 Bulimia nervosa
F60.3 Emotionally unstable personality disorder
F91 Conduct disorders
F98.0 Enuresis inorganic nature
Depression different etiology (especially with severe anxiety and agitation), including: endogenous, involutional, reactive, neurotic, with organic brain damage, drug; schizophrenic psychoses, mixed emotional disorders, behavioral disorders, bulimia nervosa, child enuresis (excluding children with hypotonia of the bladder), chronic pain (neurogenic nature), migraine prevention.
Indications for use
Treatment of all forms of endogenous depression (neurotic and reactive);
Treatment of depressive state in manic-depressive psychosis;
Treatment involutional depression;
Treatment of depressive-apathetic syndromes, developed on the background of cerebral arteriosclerosis;
Can be used in combination with amitriptyline in the treatment of depression, appeared later treatment with reserpine;
It can be used in conjunction with antipsychotics for the treatment of depression, which were the result of treatment of schizophrenic psychosis.
Hypersensitivity, the use of MAO inhibitors in the previous 2 weeks, myocardial infarction (acute and recovery periods), heart failure decompensation, violation of intracardiac conduction, expressed arterial hypertension, benign prostatic hyperplasia, bladder atony, paralytic ileus, pyloric stenosis, ulcer gastric and duodenal ulcer in the acute stage, acute liver disease and / or kidney with severe disturbance of their function, blood disorders, children up to 6 years (for injectable forms — up to 12 years).
Pregnancy and breast-feeding
Contraindicated during pregnancy.
Category effects on the fetus by FDA — C.
At the time of treatment should stop breastfeeding.
Conditional blockade of peripheral m-cholinergic receptors: dry mouth, urinary retention, constipation, intestinal obstruction, impaired vision, paresis of accommodation, increased intraocular pressure, increased sweating.
From the nervous system and sensory organs: headache, dizziness, ataxia, fatigue, weakness, irritability, drowsiness, insomnia, nightmares, motor agitation, tremor, paresthesia, peripheral neuropathy, EEG changes, impaired concentration, dysarthria, confusion , hallucinations, tinnitus.
Cardio-vascular system: tachycardia, orthostatic hypotension, arrhythmia, labile blood pressure, expansion of the QRS complex on the ECG (violation of intraventricular conduction), symptoms of heart failure, fainting, changes in the blood picture, including agranulocytosis, leukopenia, eosinophilia, thrombocytopenia, purpura.
From the digestive tract: nausea, vomiting, heartburn, anorexia, epigastric discomfort, gastralgia, increase in liver transaminases, stomatitis, taste disturbance, darkening of the tongue.
From a metabolism: galactorrhea, change ADH secretion; rarely — hypo- or hyperglycemia, impaired glucose tolerance.
With the genitourinary system: changes in libido, potency, testicular swelling, glucosuria, pollakiuria.
Allergic reactions: skin rash, pruritus, angioedema, urticaria.
Other: increase in the size of the mammary glands in men and women, hair loss, swollen lymph nodes, photosensitivity, increased body weight (with prolonged use), withdrawal symptoms: headache, nausea, vomiting, diarrhea, irritability, sleep disturbances with vivid, unusual dreams , irritability (after long-term treatment, especially in high doses, the sudden discontinuation of the drug).