These days, it is most commonly prescribed for chronic pain, especially “nerve pain.” Similarly, it can be prescribed to prevent chronic headaches.
Years ago, it was first used for depression and anxiety. However, that was at much higher doses which typically caused too many side effects. The same neurotransmitters (chemicals that send signals in the brain) that affect pain also affect pain. So the two often go together.
Nortriptyline can also have some smoking cessation effects for those who wish to quit smoking.
Possible Side Effects
The most common side effect is sedation and drowsiness. This can be a benefit if people are having trouble sleeping as well. However, it can be a problem if people still feel too tired from the medication when waking in the morning. It can also cause dizziness or confusion.
So, people need to be extra careful not to drive if they are drowsy from taking this medication. Also, they should avoid combining these pills with alcohol or other sedating medications.
If the initial drowsiness is mild and tolerable, it usually improves after a taking the medication for a little while.
Another common side effects can be dry mouth.
How to take this medication
This is usually a medication you take ONCE BEFORE BEDTIME. There are long term medications that you need to take it every night, not just as needed. It’s not like typical pain medication like Tylenol or Advil where you take them now and get pain relief thirty minutes later.
You will start at a low dose and then increase the dose, as tolerated.
Usually, you start by taking a 10mg pill at night. If you get mild side effects, then hold steady at that dose until your body gets used to it and the side effects disappear.
Then you can try increasing to TWO 10mg pills (total 20mg) each night. Again, hold steady at that dose until your body gets used to it and the side effects disappear.
If needed, you can repeat this process of increasing the dose by a 10mg each night, as tolerated, up until 50mg each nigh (5 x 10mg pills). The doses can be increased further, but please contact your doctor or nurse practitioner before doing so.
Remember that it may take a few weeks for the PAIN RELIEF to start taking effect. Think of this as the medication takes time to “get into your system”. However, the sedating side effects will be immediate, the first time you take it.
Disclaimer: this is just the general and common advice regarding this medication that Dr. Stewart tells his patients. It is not intended to be a complete list of all the information about this medication. For complete information, please click on the product monograph here, or contact your pharmacist.