Nortriptyline

Inhibition of dopamine: stimulant action. Inhibition of noradrenalin and 5HT uptake: associated with anti depressant activity. 3rd Inhibition of 5th: Uptake: Responsible for sedation.

INDICATIONS.’Neurotic, reactive, masked endogenous recurrent depression - Depression with insomnia. - Manic depressive psychosis. - E Neurosis.

CONTRAINDICATIONS: Acute myocardial in¬fraction, Narrow angle glaucoma and Urinary reten¬tion.

SAFETY PROFILE: Patients with hepatic and cardiac diseases, suffering from epilepsy, Prostatic enlargement. Diabetic and patients suffer¬ing from hyperthyroidism. Treatment should not con¬tinue for longer than 3 months.

ADVERSE EFFECTS: - Nausea, epigastric distress, dryness of mouth, constipation. -Sedation, confusion, impaired alertness, -cardiac arrhythmia. -Defects in vision Jaundice.

DRUG INTERACTIONS: - Clonidine: hypertensive crisis. L-dopa: bioavailability of L-dopa decreased hypertensive episodes. -Oral contraceptives: increased plasma level of N-tryptiline. Dicoumarol: increased anti coagulant activity. Barbiturates: increased respiratory depression.

DOSAGE: Adults 50-150mg. in single or divided doses. Children: upto 8-11 years 10-20mg/day. Over 11 yrs. 25-35mg/day. Dose should be given at the bed time with food to reduce GI irritation.