Nortriptyline is not an MAO inhibitor. It inhibits the activity of such diverse agents as histamine, 5-hydroxytryptamine, and acetylcholine. It increases the pressor effect of norepinephrine but blocks the pressor response of phenethylamine. Studies suggest that nortriptyline interferes with the transport, release, and storage of catecholamines. Indications and Usage Nortriptyline is indicated for the relief of symptoms of depression.
Endogenous depressions are more likely to be alleviated than are other depressive states.
Hyperpyretic crises, severe convulsions, and fatalities have occurred when similar tricyclic antidepressants were used in such combinations. It is advisable to have discontinued the MAO inhibitor for at least two weeks before treatment with Nortriptyline is started. Patients hypersensitive to Nortriptyline should not be given the drug. Cross-sensitivity between Nortriptyline and other dibenzazepines is a possibility. Nortriptyline is contraindicated during the acute recovery period after myocardial infarction.