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Pamelor Side Effects

Generic name: nortriptyline

Medically reviewed by Last updated on Apr 10, 2023.

Note: This document contains side effect information about nortriptyline. Some dosage forms listed on this page may not apply to the brand name Pamelor.

Applies to nortriptyline: oral capsules and oral solution.


  • Antidepressants may increase risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults (18–24 years of age) with major depressive disorder and other psychiatric disorders; balance this risk with clinical need.h i Nortriptyline is not approved for use in pediatric patients.a (See Pediatric Use under Cautions.)

  • In pooled data analyses, risk of suicidality was not increased in adults >24 years of age and apparently was reduced in adults ≥65 years of age with antidepressant therapy compared with placebo.h i

  • Depression and certain other psychiatric disorders are themselves associated with an increased risk of suicide.h i j

  • Appropriately monitor and closely observe all patients who are started on nortriptyline therapy for clinical worsening, suicidality, or unusual changes in behavior; involve family members and/or caregivers in this process.h i j (See Worsening of Depression and Suicidality Risk under Cautions.)

Side effects include:

Anticholinergic effects (e.g., dry mouth, constipation, vision disturbance), orthostatic hypotension, sedation, weakness, lethargy, fatigue.

For Healthcare Professionals

Applies to nortriptyline: compounding powder, oral capsule, oral solution.

Nervous system

Frequency not reported: Alteration in electroencephalogram (EEG) patterns, ataxia, dizziness, drowsiness, extrapyramidal symptoms, extremity paresthesia, headache, incoordination, mydriasis, numbness, peculiar taste, peripheral neuropathy, seizures, stroke, tingling, tremors[Ref]


Frequency not reported: Agitation, anxiety, confusional states with hallucinations, delusions, disorientation, exacerbation of psychosis, hypomania, increased/decreased libido, insomnia, nightmares, panic, restlessness, suicidal behaviors, suicidal ideation[Ref]


Frequency not reported: Abdominal cramps, black tongue, constipation, diarrhea, dry mouth, epigastric distress, gingivitis, nausea, paralytic ileus, parotid swelling, stomatitis, sublingual adenitis, tongue edema, vomiting[Ref]


Frequency not reported: Arrhythmias, edema, flushing, general edema, heart block, hypertension, hypotension, myocardial infarction, palpitation, tachycardia

Postmarketing reports: Brugada syndrome[Ref]


Frequency not reported: Breast enlargement, delayed micturition, dilation of the urinary tract, galactorrhea, impotence, nocturia, urinary frequency, urinary retention, testicular swelling[Ref]


Frequency not reported: Alopecia, face edema, itching, perspiration, petechia, photosensitization, skin rash, urticaria[Ref]


Frequency not reported: Agranulocytosis, aplastic anemia, bone marrow depression, eosinophilia, purpura, thrombocytopenia[Ref]


Frequency not reported: Drug fever, fatigue, malaise, tinnitus, weakness[Ref]


Frequency not reported: Altered liver function, hepatitis, jaundice (simulating obstructive), liver necrosis[Ref]


Frequency not reported: Anorexia, elevation/depression of blood sugar levels, weight gain/loss[Ref]


Frequency not reported: Blurred vision, disturbance of accommodation

Postmarketing reports: Angle-closure glaucoma[Ref]


Frequency not reported: Gynecomastia, syndrome of inappropriate antidiuretic hormone (SIADH) secretion[Ref]


Frequency not reported: Cross sensitivity (with other tricyclic drugs)[Ref]


Frequency not reported: Increased risk of bone fractures[Ref]

Frequently asked questions


1. Product Information. Pamelor (nortriptyline). Sandoz Pharmaceuticals Corporation. 2002.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.