Patient/caregiver was instructed on precautions to be exercised while taking nortriptyline as follows:
- Nortriptyline use can sometimes increase the risk for deterioration and worsening of clinical symptoms of mood disorders. Continue taking nortriptyline, as recommended, even if your mood feels better and discontinuing the medication abruptly, without your physician’s recommendation, can result in disruption of chemical balance in the brain, resulting in worsening of mood disorder and severe withdrawal symptoms. Individuals can present with complaints such as, feeling low, anxiety, panic attacks, trouble sleeping, gross appetite changes, impulsiveness, agitation, aggression, hallucinations, mania, and suicidal thoughts. Report any continuing/deteriorating symptoms of mood disorder immediately to your physician, so that, a dose change or change in plan of care could be considered.
- Nortriptyline takes some time to fairly balance the chemicals in the brain, before any improvement in mood and behavior are noted. It could take about 3 – 6 weeks to see this change in mood. So, do not discontinue taking the medication without consulting your physician, as you failed to see the improvement with depression and anxiety symptoms immediately after taking the medication.
- Intake of nortriptyline induces relaxation of urinary bladder, prevent/reduce episodes of bladder contraction, induce retention of urine in the bladder, and cause difficulty with emptying the bladder. Retention of urine in the bladder is a significant factor contributing to development of UTI. Individuals with history of retention of urine and frequent urinary tract infections must be aware of this side-effect of nortriptyline, as the medication can exacerbate this risk significantly. Observing compliance with proper hydration measures, compliance with daily fluid intake recommendations, practicing hygiene & timed voiding with other UTI prevention measures can help reduce the risk of urinary retention and prevent development of any UTIs, secondary to nortriptyline intake.
