Common questions about nortriptyline

Nortriptyline is from a group of antidepressants called tricyclic antidepressants.

If you're taking it for pain relief, it will change the way that your nerves receive pain signals so your pain.

If you're taking nortriptyline for depression, it's thought to work by increasing a chemical called serotonin in the brain. This helps to improve your mood.

If you take nortriptyline to treat nerve pain, it usually takes a week or so for pain to begin to get better. You may start to sleep better at night.

If you take nortriptyline for depression, you may start to feel better after a couple of weeks. It can take 4 to 6 weeks until you feel the full benefits.

Do not stop taking nortriptyline just because you feel it's not helping your symptoms. Give it at least 6 weeks to work.

Although nortriptyline is an antidepressant, it can be taken to help with pain. The doses are lower if you take it for pain. Taking nortriptyline as a painkiller will not have the same effects as taking it for depression.

If you're taking nortriptyline for depression, it helps to lift your mood gradually, so you feel better. You may get on with people more easily because you're less anxious. You'll hopefully be more relaxed about things that used to worry you

Nortriptyline will not change your personality. It will simply help you feel like yourself again.

Do not expect to feel better straight away though. Some people feel worse during the first few weeks of treatment before they begin to feel better.

When nortriptyline is taken for nerve pain, most people can sleep better within a few days and the pain starts to get better off after a week or so.

If your pain does not get better or you have side effects, talk to your doctor as there may be other treatments which work for you.

Talk to your doctor if you take nortriptyline for depression and you do not feel better after taking it for 6 weeks, or the side effects bother you.

For most people, nortriptyline is safe to take for a long time.

There do not seem to be any lasting harmful effects from taking nortriptyline for many months or years.

Nortriptyline is not addictive.

You may get withdrawal side effects when you stop taking nortriptyline, especially if you stop taking it suddenly.

These side effects are a physical reaction as the medicine leaves your body. They can include sweating, feeling or being sick, feeling anxious, feeling weak, headache and difficulty falling asleep.

To help prevent them, your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you’ve been taking nortriptyline for a long time.

Paracetamol and ibuprofen are safe to take with nortriptyline for a short time. Talk to your doctor if you need to take them for more than a few days.

Nortriptyline is usually prescribed by your doctor if other painkillers, such as paracetamol and ibuprofen, have not worked.

Nortriptyline does not work any better or worse than other medicines for nerve pain.

Nortriptyline does not work any better or worse than other antidepressants. However, sometimes people respond better to one antidepressant than another.

The best antidepressant for you depends on your symptoms and what medicines have worked for you in the past.

Talk to your doctor if you're not feeling any better after taking nortriptyline for 6 weeks or if the side effects still bother you.

Taking nortriptyline can occasionally cause low sex drive (loss of libido) or it can sometimes increase your sex drive.

Sexual side effects are not very common and should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to your doctor to see if there's another medicine you can try.

Nortriptyline can change how hungry you feel. Some people feel more hungry when they're taking it, and others feel less hungry. So your weight may change when you first start taking it.

If you start to have problems with your weight while taking nortriptyline, talk to your doctor or pharmacist.

Nortriptyline does not affect any type of contraception including the combined pill and emergency contraception.

However, if nortriptyline makes you vomit or have severe, watery diarrhoea, or any diarrhoea that lasts for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Check the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Some people feel sleepy while they're taking nortriptyline. It's best to stop driving, cycling or operating machinery for the first few days and after each dose increase, until you know how this medicine makes you feel.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking nortriptyline.

Find out more about the law on driving:

• GOV.UK: Medical conditions, disability and driving
• GOV.UK: Drugs and driving: the law

You can drink alcohol while taking nortriptyline, but it may make you feel sleepy. It might be best to stop drinking alcohol until you see how the medicine makes you feel.

Apart from being extra careful about how much alcohol you drink, you can eat and drink normally while taking nortriptyline.

Cannabis with nortriptyline can make you feel very sleepy, especially if you've just started taking it. Cannabis can also give you a fast heartbeat.

It may be dangerous to take nortriptyline with:

• methadone
• stimulants like MDMA (ecstasy) or cocaine
• hallucinogens like LSD
• novel psychoactive substances (these used to be called "legal highs") like mephedrone

Nortriptyline has not been properly tested with recreational drugs. Talk to your doctor if you think you might use recreational drugs while taking nortriptyline.

Find out more about the effects of recreational drugs on the Frank website.