As with all prescription drugs, nortriptyline comes with the risk of certain side effects. Here’s a guide to what you need to watch out for when taking this medication.
Side Effects of Nortriptyline
Like other medications, nortriptyline can have potential side effects. Not everyone will experience all of these side effects, and the severity can vary from one person to the next.
Common Side Effects
The most common side effects of nortriptyline include:
Blurred VisionConstipationDizzinessDrowsinessDry mouthHeadacheIncreased appetite, possibly with a craving for sweetsNauseaTiredness or mild weaknessWeight gain
Generally, these common side effects are mild and can be managed with lifestyle changes. If you find they’re problematic, persistent, or worsen over time, however, talk to your doctor.
Potentially Serious Side Effects
These side effects of nortriptyline aren’t very common, but they’re potentially serious when they do occur. If you experience any of these, contact your doctor about them right away. Less common (but potentially serious) side effects include:
Confusion Difficulty in speaking or swallowing Eye pain Fainting Fast or irregular heartbeat (such as pounding, racing, or skipping) Hallucinations Increased liver functions Loss of balance Mania Nervousness or restlessness Problems urinating Seizures Sexual side effects Stiffness of arms and legs
Discontinuing Nortriptyline
If you reduce your dose or stop taking your medication, you may experience symptoms of nortriptyline withdrawal. Never stop taking a medication without consulting your doctor. If you and your doctor decide you should stop taking nortriptyline, your doctor may recommend gradually tapering or reducing your dose. Discontinuing the drug all at once can lead to discontinuation syndrome which includes flu-like symptoms such as headache, nausea, irritability, vomiting or diarrhea, restlessness, trouble sleeping, vivid dreams, and unusual excitement.
Nortriptyline Overdose
It’s also possible to overdose on nortriptyline and other tricyclic antidepressants. Signs of overdose can develop quickly and require immediate medical attention. Symptoms of an overdose include:
ConfusionConvulsions (seizures)Disturbed concentrationEnlarged pupilsFast, slow, or irregular heartbeatFeverHallucinations (seeing, hearing, or feeling things that are not there)Restlessness and agitationSevere drowsinessShortness of breath or troubled breathingUnusual and severe tiredness or weaknessVomiting
If any of these symptoms occur, seek emergency medical help.
Precautions
There are important precautions to consider before you begin taking nortriptyline. You should not take this medication if:
You are allergic to it or to similar medications including amoxapine, desipramine, or imipramine.You are allergic to the seizure medications carbamazepine, eslicarbazepine, oxcarbazepine, or rufinamideYou have recently experienced a heart attackYou have taken an MAO inhibitor within the previous 14-day period
Dosage
The standard nortriptyline dosage for adults is 25 mg taken three to four times each day. The maximum daily dose is 150 mg per day.
Interactions
Nortriptyline can also interact with other medications. Such interactions can affect how each medication works or lead to unwanted side effects. Some medications that can lead to interactions include:
AntidepressantsCold or allergy medicationsMedications to treat irritable bowel syndrome (IBS)Bronchodilators to treat asthmaParkinson’s disease medicationsStimulants to treat attention-deficit hyperactivity disorder (ADHD)
Always tell your doctor if you are taking other medications, supplements, herbal remedies, or illicit substances.
A Word From Verywell
While most people who take nortriptyline do not experience serious side effects from the medication, even mild side effects can be bothersome. When starting a new medication or adjusting your dosage, be sure to note any new or worsening symptoms and discuss them with your doctor. Together you can develop a plan to get the most out of nortriptyline’s desired effects and manage unwanted side effects.
