Generic Name: Pamelor
What is Pamelor?
The same thing also happens with Desipramine, being a metabolite of Imipramine, after awhile, some people find it activating, and insomnia can be a problem. I am not a doctor. So it's better if you can talk about this matter to your doctor. I have an idea of why your doctor chooses Nortriptyline, a secondary amine, it can be because of it lacking in anticholinergic effect dry mouth, constipationcompared to the Tertiary Amines, Amitriptyline.
For insomnia, 25mg to 50mg is enough to put me to sleep with Amitriptyline. To me, Nortriptyline causes insomnia, in long term, especially after my body get adjusted to its effect. For Panic,anxiety and fear, Imipramine 10mg-25mg once or twice a day works better than other Tricyclics.
Desipramine, to me, caused insomnia, agitation and a more pronounced irregular heart-beat, it does nothing for panic or anxiety. Posted July 13, 2009Found your post while googling the same concern -- I'll make myself at least bookmark the monographs that come up on a search, but wikipedia.
Severe hypertensive crises, serotonin syndrome, or increased anticholinergic effects can result from concomitant use. Under careful monitoring for signs or symptoms of hypertension, add the MAOI gradually, starting at a low dose. Patients should also be monitored closely for signs or symptoms of serotonin syndrome characterized by hyperthermia, diaphoresis, shivering, tremor, myoclonus, seizures, ataxia, delirium, restlessness.
Strict adherence to diet restrictions should be emphasized and the patient should not be receiving other sympathomimetics. Most references suggest avoiding this drug interaction entirely if clomipramine or imipramine are being administered.
Prochlorperazine: When prescribing tricyclic antidepressants TCAs to patients already receiving phenothiazine therapy, close monitoring is essential and dose reduction may become necessary to avoid toxicity. Promethazine: Promethazine carries a risk of QT prolongation and should be used cautiously with drugs that may prolong the QT interval and have additive anticholinergic properties such as the tricyclic antidepressants.
Propafenone: Tricyclic antidepressants TCAs share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy elevated serum concentrations. Cases of long QT syndrome and torsade de pointes TdP tachycardia have been described with TCA use, but rarely occur when TCAs are used alone in normal prescribed doses and in the absence of other known risk factors for QT prolongation.
Certain cardiac drugs prolong repolarization at therapeutic or elevated plasma concentrations, and the addition of other drugs may increase the risk of QT prolongation and TdP via pharmacokinetic or pharmacodynamic interactions.
TCAs should be used cautiously and with close monitoring in combination with cardiac drugs known to prolong the QT interval such as propafenone. Propantheline: Depending on the specific agent, additive anticholinergic effects may be seen when tricyclic antidepressants TCAs are used concomitantly with other anticholinergics.
Propofol: General anesthetics like propofol may produce additive CNS depression when used in patients taking tricyclic antidepressants. Propoxyphene: As propoxyphene inhibits CYP2D6, increased effects of tricyclic antidepressants that are CYP2D6 substrates, such as amitriptyline, clomipramine, desipramine, doxepin, imipramine, and nortriptyline, may be seen with concomitant use.
How should I take Pamelor?
You should discuss all of your medical problems with your doctor before taking this medication. If you are being treated for a severe mental disorder schizophrenia or manic depressiontell your doctor before taking Pamelor.
Pamelor may make your skin more sensitive to sunlight. Try to stay out of the sun, wear protective clothing, and apply a sun block. Before having surgery, dental treatment, or any diagnostic procedure, tell your doctor that you are taking Pamelor.
Certain drugs used during these procedures, such as anesthetics and muscle relaxants, may interact with Pamelor. If Pamelor is taken with certain other drugs, the effects of either can be increased, decreased, or altered.
It is especially important to check with your doctor before combining Pamelor with the following:Airway-opening drugs such as Ventolin and Proventil Antidepressants such as Wellbutrin and Desyrel Antidepressants that act on serotonin, such as Prozac, Paxil, and Zoloft Blood pressure medications such as Catapres and Esimil Cimetidine Tagamet Chlorpropamide Diabinese Drugs for heart irregularities, such as Tambocor and Rythmol Drugs that control spasms, such as Donnatal and Bentyl Levodopa Larodopa Major tranquilizers such as Thorazine and Mellaril Quinidine Quinidex Reserpine Diupres Stimulants such as Dexedrine Thyroid medication such as Synthroid Warfarin Coumadin The effects of Pamelor during pregnancy have not been adequately studied.
What should I avoid while taking Pamelor?
Dronedarone administration is associated with a dose-related increase in the QTc interval. The increase in QTc is approximately 10 milliseconds at doses of 400 mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of 1600 mg twice daily.
Although there are no studies examining the effects of dronedarone in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation. Droperidol: Tricyclic antidepressants should be used cautiously and with close monitoring with droperidol. Droperidol should be administered with extreme caution to patients receiving other agents that may prolong the QT interval. Droperidol administration is associated with an established risk for QT prolongation and torsades de pointes TdP.
In December 2001, the FDA issued a black box warning regarding the use of droperidol and its association with QT prolongation and potential for cardiac arrhythmias based on post-marketing surveillance data.
Pamelor side effects
A: Nortriptyline is in a drug class called tricyclic antidepressants. Nortriptyline is used to treat depression. Nortriptyline can cause anticholinergic effects. Anticholinergic effects are caused by medications that stop the action of acetylcholine, which is a chemical messenger that helps nerve cells exchange messages.
Acetylcholine assists with many functions in the body, including learning, concentration, and memory. Acetylcholine also helps direct the function of the heart, blood vessels, airways, urinary tract, and digestive tract.
Common Pamelor ide effects may include:
Drugs with a possible risk for QT prolongation and torsade de pointes TdP that should be used cautiously with ezogabine include tricyclic antidepressants TCAs.
Ranolazine: Ranolazine is associated with dose- and plasma concentration-related increases in the QTc interval.
Do inform your doctor if you have glaucoma, urinary problems, thyroid disorders, diabetes, schizophrenia or any bipolar disorder.
Advertisement Nortriptyline oral capsule may cause drowsiness.
Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with TCAs include the beta-agonists. Beta agonists infrequently produce cardiovascular adverse effects, mostly with high doses or in the setting of beta-agonist-induced hypokalemia.
Loperamide: Coadministration of loperamide with tricyclic antidepressants TCAs may rarely increase the risk for QT prolongation and torsade de pointes TdP. High doses of loperamide have also resulted in serious cardiac toxicities i.
Where can I get more information?
If serotonin syndrome is suspected, tricyclic antidepressants and concurrent serotonergic agents should be discontinued.
Due to individual variability in response to antidepressants, it may be prudent to continue the existing regimen if ongoing treatment is deemed necessary during breast-feeding.