Nortriptyline

Nortriptyline

Clinical data
Trade names	Aventyl
AHFS/Drugs.com	Monograph
MedlinePlus	a682620
Pregnancy category	AU: C
Routes of administration	Oral
ATC code	N06AA10 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability	High
Metabolism	Hepatic
Biological half-life	16 and 90 hours
Excretion	Renal
Identifiers
IUPAC name 3-(10,11-Dihydro-5H-dibenzo[a,d]cyclohepten-5-ylidene)-N-methyl-1-propanamine
CAS Number	72-69-5 Y
PubChem CID	4543
IUPHAR/BPS	2404
DrugBank	DB00540 Y
ChemSpider	4384 Y
UNII	BL03SY4LXB
KEGG	D08288 Y
ChEBI	CHEBI:7640 Y
ChEMBL	CHEMBL445 Y
ECHA InfoCard	100.000.717
Chemical and physical data
Formula	C19H21N
Molar mass	263.38 g/mol
3D model (Jmol)	Interactive image
SMILES c3cc2c(/C(c1c(cccc1)CC2)=C/CCNC)cc3
InChI InChI=1S/C19H21N/c1-20-14-6-11-19-17-9-4-2-7-15(17)12-13-16-8-3-5-10-18(16)19/h2-5,7-11,20H,6,12-14H2,1H3 Y Key:PHVGLTMQBUFIQQ-UHFFFAOYSA-N Y

Nortriptyline is a second-generation tricyclic antidepressant (TCA) marketed as the hydrochloride salt under the trade names Sensoval, Aventyl, Pamelor, Norpress, Allegron, Noritren and Nortrilen. It is used in the treatment of major depression and childhood nocturnal enuresis (bedwetting). Its off-label uses include treatment of chronic fatigue syndrome,chronic pain and migraine, and labile affect in some neurological disorders.

Nortriptyline is US FDA-approved for the treatment of major depression. In the United Kingdom, it may also be used for treating nocturnal enuresis, with courses of treatment lasting no more than three months. It is also used off-label for the treatment of panic disorder, irritable bowel syndrome, migraine prophylaxis and chronic pain or neuralgia modification, particularly temporomandibular joint disorder. It can also aid in quitting smoking, with one study showing a six-month abstinence rate of 14% for subjects receiving nortriptyline compared to 3% for subjects not undergoing pharmacological treatment. A controlled study suggests it reduces symptoms of ADHD.

Although not approved by the FDA for neuropathic pain, many randomized controlled trials have demonstrated the efficacy of tricyclic antidepressants for the treatment of this condition in both depressed and non-depressed individuals. Recently, an evidence-based guideline sponsored by the International Association for the Study of Pain recommends nortriptyline as a first-line medication for neuropathic pain.