Nortriptyline Side Effects

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Nortriptyline is a tricyclic antidepressant sometimes sold under the brand names Pamelor and Aventyl (other brand names exist outside the U.S.). The medication may be used in the treatment of mood disorders such as depression, anxiety disorders and also for some other conditions, including migraine headaches, bedwetting, and chronic pain.

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.

Common Side Effects

The most common side effects of nortriptyline include:

  • Blurred Vision
  • Constipation
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Headache
  • Increased appetite, possibly with a craving for sweets
  • Nausea
  • Tiredness or mild weakness
  • Weight 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

Allergic reactions to nortriptyline are also rare, but possible. If you experience signs of an allergic reaction such as rash/hives, itching, swelling (especially of the face, lips, tongue, or throat), or trouble breathing, seek immediate medical care.

Discontinuing Nortriptyline

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:

  • Confusion
  • Convulsions (seizures)
  • Disturbed concentration
  • Enlarged pupils
  • Fast, slow, or irregular heartbeat
  • Fever
  • Hallucinations (seeing, hearing, or feeling things that are not there)
  • Restlessness and agitation
  • Severe drowsiness
  • Shortness of breath or troubled breathing
  • Unusual and severe tiredness or weakness
  • Vomiting

If any of these symptoms occur, seek emergency medical help.

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.

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6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Derry S, Wiffen PJ, Aldington D, Moore RA. Nortriptyline for neuropathic pain in adults. Cochrane Database Syst Rev. 2015;1:CD011209. doi:10.1002/14651858.CD011209.pub2

  4. U.S Food and Drug Administration. Pamelor (nortriptyline HCl) capsules USP. 

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