Nortriptyline (Pamelor/Aventyl)

Nortriptyline (Trade names: Pamelor, Aventyl) is a tricyclic antidepressant. It has the lowest anticholinergic (and least hypotensive) burden of the TCA class, and is therefore useful in geriatric depression.[1]

  • Nortripyline can be started at 10mg daily and be titrated up by 10-25 mg every 2 weeks, up to a maximum recommended dose of 150 mg (target dose range: 75mg to 100 mg). It can be given as a single daily dose, or in divided doses.
  • Nortriptyline has a curvilinear (i.e. - nonlinear) relationship between its levels and therapeutic response.[2]
  • Tmax = 4-8 hours
  • Half-life = 15-20 hours
  • Nortriptyline is a metabolite of amitriptyline

Insomnia: 10-75mg

  • Most individuals have an optimal response to nortriptyline with serum levels between 70 and 170 ng/mL.[3]