Nortriptyline Side Effects

Woman with a headache

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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 bipolar disorder, other mood disorders such as depression, 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:

  • Dizziness
  • Drowsiness
  • Dry mouth or an unpleasant taste in your 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.

Less Common Side Effects

The following nortriptyline side effects are not seen as frequently as those above, but may still occur:

  • Diarrhea
  • Heartburn
  • Increased sweating
  • Trouble sleeping (more common with the related medication protriptyline, especially when taken late in the day)
  • Vomiting

If any of these side effects occur, discuss them with 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:

  • Blurred vision
  • Confusion or delirium
  • Constipation (especially in seniors)
  • Decreased sexual ability (more common with the related medications amoxapine and clomipramine)
  • Difficulty in speaking or swallowing
  • Eye pain
  • Fainting
  • Fast or irregular heartbeat (such as pounding, racing, or skipping)
  • Hallucinations
  • Loss of balance
  • Mask-like face
  • Nervousness or restlessness
  • Problems urinating
  • Shakiness or trembling
  • Shuffling walk
  • Slowed movements
  • Stiffness of arms and legs

Rare (but potentially serious) side effects include:

  • Anxiety
  • Breast enlargement (in both men and women)
  • Inappropriate secretion of milk in women
  • Increased sensitivity to sunlight
  • Irritability
  • Twitching muscles
  • Red or brownish spots on the skin
  • Ringing, buzzing, or other unexplained sounds in the ears
  • Seizures (more common with related medication clomipramine)
  • Skin rash and itching
  • Sore throat and fever
  • Swelling of face and tongue
  • Swelling of testicles (more common with the related medication amoxapine)
  • Trouble with teeth or gums (more common with the related medication clomipramine)
  • Severe weakness
  • Yellow eyes or skin

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.

Side Effects of 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 as discontinuing the drug all at once can lead to side effects such as a headache and nausea.

Other potential side effects as you're stopping nortriptyline can include irritability, vomiting or diarrhea, restlessness, trouble sleeping, vivid dreams, and unusual excitement.

Symptoms of Nortriptyline Overdose

It's also possible to overdose on nortriptyline and other tricyclic antidepressants. Signs of overdose develop quickly and require immediate medical attention.

Symptoms of an overdose include: confusion; convulsions (seizures); disturbed concentration; severe drowsiness; enlarged pupils; fast, slow, or irregular heartbeat; fever; hallucinations (seeing, hearing, or feeling things that are not there); restlessness and agitation; shortness of breath or troubled breathing; unusual and severe tiredness or weakness; and 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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