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What are the Common Nortriptyline Side Effects?

By Angela Crout-Mitchell
Updated: Feb 29, 2024

Like most prescription drugs, the antidepressant nortriptyline can produce side effects. Some of the most common nortriptyline side effects include constipation, confusion, and problems with urination. This drug may also cause drastic changes in weight, dizziness, and drowsiness. More serious complications associated with this type of depression medication are an increased risk of heart attack and stroke, panic attacks, swelling of the testicles for men, and abnormal changes in breast tissue for women. The side effect symptoms can be controlled by modifying the drug dosage or changing medications all together, as recommended by a qualified medical professional.

It is not unusual for the nortriptyline side effects to be relatively minor, though any problems should be reported to the patient's physician as quickly as possible. Many depression patients taking tricyclic antidepressants experience problems with chronically dry mouth, difficulty during urination, and often constipation as well. Some of the other common side effects include increased perspiration and lowered sex drives in both genders. Male patients have also reported symptoms of erectile dysfunction (ED) when taking antidepressants of this nature.

The nortriptyline side effects can be more serious, and have a greater impact on the patient's life. Some people taking this medication have reported symptoms such as dizziness, difficulty staying awake even during regular daily activities, and feelings of confusion. The use of this drug is carefully monitored, especially for people with diabetes, as it has been attributed to unusual changes in blood sugar levels. It is suggested that patients using nortriptyline report any irritating or chronic side effects to their physician. Usually, modifications to the dosage may be implemented to reduce the likelihood of side effects.

The most severe category of common nortriptyline side effects includes both physical and psychological symptoms. People who experience these reactions may have suicidal thoughts, hallucinations and severe confusion, as well as exhibit aggressive and hostile behaviors towards those around them. Other types of psychological side effects of this drug are extreme mood swings, an unexplained tendency to engage in risky and dangerous activities, and problems focusing on tasks. Any unusual change in behavior or mood should be immediately reported to the prescribing doctor.

Serious physical reactions are also possible when taking nortriptyline. Some patients have experienced heart arrhythmia, heart palpitations, and an increased heart rate. Many serious side effects mimic an allergic reaction and manifest with the appearance of skin rashes, difficulty breathing, and extreme itching. Seizures, heart attacks, and strokes may also occur when taking this medication. Though these side effects are rare, most medical professionals educate their patients to the dangers and closely monitor any side effects that occur.

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Discussion Comments
By SarahGen — On Nov 05, 2013

@fBoyle-- I agree with you. If your doctor is not taking you seriously, you need to see a different one. If you noticed, the article mentioned arrhythmia as a serious side effect.

I was on nortriptyline for insomnia, not depression. It definitely helped me sleep but it worked too well and made me sleepy during the day too. I had to quit it because I couldn't concentrate on work and weaned myself off slowly.

By fBoyle — On Nov 04, 2013

I get heart palpitations on nortriptyline. I told my doctor about it but he doesn't believe me. I have anxiety in addition to depression and he thinks that it's just me being anxious. But if palpitations are in the list of possible side effects, I can definitely have them. I think I need a new doctor.

By bear78 — On Nov 04, 2013

Tricyclic antidepressants seem to have the same side effects. I've been on several and I had dry mouth, drowsiness, fatigue and weight gain with every medication. Some are better than others though. Like, nortriptyline is much better than amitriptyline. The side effects are less intense and bothersome, but there nonetheless.

This is probably why doctors don't prescribe this group of antidepressants frequently. They prefer SSRIs (selective serotonin reuptake inhibitors). I personally do too. They have the least side effects of all antidepressant medications.

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