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NORTRIPTYLINE WITHDRAWAL SYMPTOMS INFO / HOW TO TAPER OFF NORTRIPTYLINE NATURALLY & SUCCESSFULLY

Succeed with our In-Home Nortriptyline taper program

It is possible to break the dependence to Nortriptlyine if the withdrawal process is done correctly. Nortriptyline Withdrawal Symptoms can include dizziness, gastrointestinal problems, anxiety, restlessness and headaches and these symptoms can be minimized by gradually decreasing the dose over time. [1 Yet for many, tapering alone is not enough. They need help to control the withdrawal symptoms. This is why our withdrawal approach implements holistic, proven, nutraceuticals (high potency food based supplements) to calm the nervous system while assisting in recovery.  Abruptly stopping Nortriptlyine can be detrimental to the patient, triggering withdrawals which increase the very symptoms you were seeking to treat. [2] 

We have 17 years of proven success in breaking the dependence to tricyclic medications and we know how to diminish the symptoms safely, without the concern of interactions that can increase withdrawals. Point of Return provides a safe, effective, medically driven protocol that is completed at your home. Dependence to Nortriptyline places extreme demands on your body and nervous system. Point of Return implements slow reduction schedules and specifically designed nutraceuticals to support the body's unique needs during a Nortriptyline taper. Let our experts guide you on how to taper off Nortriptyline with the correct taper rates; ways to promote sleep without an interaction with the Nortriptyline; while providing the encouragement you need to be successful. Break the dependence to Nortriptyline.  Point of Return provides you real hope and a opportunity at success, please contact us today*

    SIGNS OF NORTRIPTYLINE DEPENDENCE

    Nortriptyline is the active metabolite of Amitriptyline and the early indicators of dependence is an increase in symptoms when attempting to reduce the Nortriptyline. In addition to interruptions in sleep patterns, daytime dizziness, nausea, hypersensitivity and mood swings, flu-like symptoms can begin as your body has adapted to the drug.[3] Changes in gut health, an increase in body aches, lethargy and cognitive decline can also occur and are indications your nervous system has been altered.  Many items (herbs, vitamins, over-the-counter) interact with Nortripytline and that is why we only use safe supplementation that promotes sleep, assist with cognitive function and overall body symptoms, yet are completely safe and will not interact.  We guide each client individually so you can step down gently at home, knowing which pitfalls to avoid and how to promote healing and true, wonderful, rejuvenating sleep.* 

     

    WHAT IS NORTRIPTYLINE WITHDRAWAL LIKE? 

    Nortriptyline was marketed under the trade name Pamelor and is also the active metabolite of Amitriptyline. It is estimated that approximately 80% of people that have used Nortriptyline for more than eight weeks and suddenly stop will develop some symptoms of withdrawal.  For some they may be mild, others may display numerous symptoms that interfere with life.  Dizziness, headaches, nausea, appetite loss, increase in pain, aching joints, sweating and psychological symptoms of anxiety, fatigue, insomnia and cognitive deficits are the most common early withdrawal symptoms.[4]  Tapering slowly is always recommended, this minimizes the withdrawal symptoms.  We also believe in healing as you taper since Nortriptyline does alter various neurotransmitters throughout the body that must heal. Our nonprofit has successfully helped people in 78 countries, now its your turn!  contact us today.*

     

    NORTRIPTYLINE WITHDRAWAL HELP - HOW TO TAPER OFF NORTRIPTYLINE NATURALLY

     

    For over 17 years, Point of Return 501(c)3 nonprofit, has successfully helped people all over the world to safely recover from Nortriptyline dependence. Our Nortriptyline withdrawal program is a proven holistic approach that allows you to step down on the medication while minimizing Nortriptyline withdrawal symptoms with proven, specifically designed nutraceuticals (high potency food based supplements that provide medical benefit) that will not interact, yet provide needed relief and promote sleep.  We are sticklers for potential interactions with specific foods, vitamins, herbs or over-the-counter items and will review anything you are currently ingesting for interaction risk. Each program is based specifically on your situation and our kind team will guide you through the process of how to taper off Nortriptyline and recover successfully. We understand the unique demands placed on the body and nervous system by Nortriptyline.  Point of Return provides healthy, proven, Drug-Free strategies to help ease Nortriptyline withdrawal symptoms while supporting your well being.*


    How to taper off Nortriptyline successfully with Point of Return

    NORTRIPTYLINE WITHDRAWAL SYMPTOMS MAY INCLUDE

     

    • drowsiness
    • dizziness 
    • dry mouth
    • blurred vision
    • constipation
    • weight gain or trouble urinating
    • myocardial infarction
    • arrhythmia
    • hypotension
    • hypertension
    • palpitation
    • tachycardia
    • coma
    • seizures
    • hallucinations; delusions
    • confused states;
    • disorientation
    • incoordination
    • tremors
    • peripheral neuropathy
    • abnormal involuntary movements
    • tardive dyskinesia
    • dysarthria
    • disturbed concentration
    • anxiety
    • insomnia
    • restlessness
    • nightmares
    • drowsiness
    • dizziness
    • weakness
    • fatigue
    • headache
    • syndrome of inappropriate ADH
    • secretion
    • tinnitus
    • hyperpyrexia
    • urinary retention
    • dilation of urinary tract
    • constipation
    • blurred vision
    • increased ocular pressure
    • skin rash
    • urticarial
    • edema of face and tongue
    • bone marrow
    • depression
    • nausea
    • vomiting
    • anorexia
    • stomatitis; peculiar taste
    • diarrhea
    • black tongue
    • testicular swelling
    • breast enlargement – female
    • increased or decreased libido
    • impotence
    • elevation and lowering of blood sugar levels
    • alopecia
    • weight gain or loss
    • urinary frequency
    • increased perspiration*

    IMAGINE BEING FREE OF NORTRIPTYLINE DEPENDENCY

     

     Proven Program completed In-Home with Expert Guidance 

    ✔ Slowly Wean Off Nortriptyline

    ✔ All-Natural Nutraceuticals to help ease symptoms and make Nortriptyline Withdrawal more comfortable*

    ✔ Professional information on interactions 

    ✔ Free Mentoring on our 24/7 private Discussion Board

    ✔ Free Assessment Upon Starting our Program (a $400 value)

     

    Enter Discount Code ADFree for FREE Ground Shipping on your Withdrawal Program (USA & Canada Only)

    NORTRIPTYLINE WITHDRAWAL TIMELINE

    Many variables can affect the duration and onset of Nortriptyline withdrawal including other medications; time on the Nortriptyline or previous medications; age; health challenges and the half-life of the drug.  Nortriptyline affects Serotonin and Norpinephrine receptors throughout the human body [5] and these chemical messengers can alter mood, pain control, levels of anxiety and sleep. [6] Thus withdrawals also are intensified complaints of the very symptoms that were initially being treated.  Missing one dose or reducing a dose by too large an amount can trigger Nortriptyline Withdrawal symptoms within a 12-24 hours. [8] The severity can vary from person to person with the acute phase beginning rapidly after missing a dose of sleeping pill. And while understanding the withdrawal timeline can be important, the timelines can vary significantly.  We prefer to place our focus on healing while gently reducing Nortriptyline. If you want help to safely taper off Nortriptyline, please contact our experts.*

    Is it Your Time to Start a New Journey?

    NORTRIPTYLINE WITHDRAWAL SUCCESS STORIES

    Liz - Overcome Nortriptyline Withdrawal Symptoms

    This experience has left me humbled and oh so grateful. Please let Point of Return work for you. They will provide the tools you need to succeed.  More...

    Liz (Nortriptyline Withdrawal Success Story)

    Helyn - how to taper off Nortriptyline

    I owe it all to you, and everyone else at Point of Return. I am forever grateful, and I will never stop telling people about Point of Return. More...

    Helyn (Nortriptyline Withdrawal Success Story)

    Robin - how to taper off Nortriptyline

    I cannot say enough good things about the entire POR team. I will be forever grateful. Thank you from the bottom of my heart. More...

    Robin (Nortriptyline Withdrawal Success Story)

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    NORTRIPTYLINE RESOURCE CENTER

     

    NORTRIPTYLINE WITHDRAWAL SYMPTOMS, SIDE EFFECTS AND ADVERSE REACTIONS ( link | pdf ) 
    NORTRIPTYLINE HISTORY AND INFO  ( link | pdf ) 
    NORTRIPTYLINE REFERENCES AND FDA INFO ( link | pdf )
    NORTRIPTYLINE WITHDRAWAL HELP (link)

      WHAT IS NORTRIPTYLINE?

       

      Nortriptyline is a 2nd generation Tricyclic Antidepressant with common side effects that include dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus, euphoria and mania. An occasional side effect is a rapid or irregular heart beat and alcohol can exacerbate side effects and should be avoided.   Nortriptyline should not be abruptly or rapidly discontinued due to the potential of severe Nortriptyline withdrawal symptoms. It is recommended to do a slow Nortriptyline taper to minimize withdrawal symptoms. Contact Us if you need help weaning off of Nortriptyline or have questions. 

      Nortriptyline Hydrochloride is the active metabolite of Amitriptyline and is considered a second-generation tricylic antidepressant (TCA). It is also marketed as Sensoval, Aventyl, Pamelor, Norpress, Allegraon, Noritren and Nortrilen.

      Notriptyline is approved for the treatment of major depression and childhood nocturnal enuresis (bedwetting), but it is also used off-label for panic disorder, irritable bowel, migraines and chronic pain. Although Nortriptyline and other Tricyclic Antidepressants are frequently prescribed for gastroparesis, a randomized clinical trial published in the December 25, 2013 issue of JAMA Medical Journal showed Nortriptyline was not more effective than placebo.

      Tricyclic Antidepressants were developed in the early 1950s amid the explosive expansion of psychopharmacology and named after their chemical structure that contains three rings of atoms. Tricyclics began with the synthesis of chlorpromazine in December 1950 and generated significant revenue as an antipsychotic by 1955. This spurred chemists to explore other derivatives. The first clinical trial took place in 1955 and it wasn't long before Tricyclics became the first choice for the treatment of depression. But due to their side effect profile, Tricylics have been largely replaced by SSRIs and other antidepressants.

      All Tricyclics, including Nortiprtyline, have a narrow therapeutic index, increasing the likelihood of an overdose (both accidental and intentional). Close monitoring is recommended for any patient on Nortriptyline with a history of cardiovascular disease, glaucoma, stroke, seizures, or hyperthyroid. Nortriptyline should not be combined with MAO Inhibitors, Turmeric or Curcumin due to the risk of Serotonin Syndrome.

      Nortriptyline should not be abruptly or rapidly discontinued due to the potential of severe withdrawal symptoms. It is recommended to do a slow taper to help minimize symptoms.

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      Miranda - Nortriptyline taper Success Story

      “ I am so very deeply grateful.  Thank you God, thank you, Point of Return.  May God constantly sustain you and continue to bless your work.

      — Helen (Nortriptyline Withdrawal Success)

      NORTRIPTYLINE SIDE EFFECTS AND ADVERSE REACTIONS 

       

      NORTRIPTYLINE SIDE EFFECTS MAY INCLUDE: 

      Dizziness, aggression, anxiety, balance issues , blurred vision, brain zaps, concentration impairment, constipation, crying spells, depersonalization, diarrhea, dizziness. electric shock sensations, fatigue, flatulence, flu-like symptoms, hallucinations, hostility, highly emotional, indigestion, irritability, impaired speech, insomnia, jumpy nerves, lack of coordination, lethargy, migraine headaches / increased headaches, nausea, nervousness, over-reacting to situations, paranoia, repetitive thoughts or songs, sensory & sleep disturbances, severe internal restlessness (akathisia), stomach cramps, tremors, tinnitus (ear ringing or buzzing), tingling sensations, troubling thoughts, visual hallucinations / illusions, vivid dreams, speech or visual changes, worsened depression

      NORTRIPTYLINE ADVERSE REACTIONS MAY INCLUDE: per PDR   

      Severe: seizures, agranulocytosis, hepatic failure, serotonin syndrome, suicidal ideation, ileus, myocardial infarction, stroke, ventricular tachycardia, heart failure, ocular hypertension, vasculitis, SIADH 

      Moderate: dysarthria. blurred vision, urinary retention, elevated hepatic enzymes, leukopenia, eosinophilia, thrombocytopenia, hyperthyroidism, hypothyroidism, goiter, jaundice, hepatitis, constipation, impotence (erectile dysfunction), ejaculation dysfunction, withdrawal, memory impairment, peripheral neuropathy, EEG changes, ataxia, delirium, mania, akathisia, hallucinations, hostility, psychosis, confusion, stomatitis, parotitis, glossitis, hypertension, QT prolongation, palpitations, orthostatic hypotension, PR prolongation, sinus tachycardia, cycloplegia, testicular swelling, galactorrhe, edema, erythema, diabetes mellitus, hyponatremia, hyperthermia

      Mild: yawning, insomnia, abdominal pain, vomiting, anorexia, diarrhea, purpura, drowsiness, dizziness, fatigue, headache, tremor, dyspepsia, xerostomia, nausea, appetite stimulation, weight gain, tinnitus, nightmares, weakness, paresthesias, irritability, restlessness, anxiety, agitation, tongue discoloration, dysgeusia / Early / Incidence not knownpyrosis (heartburn, mydriasis, breast enlargement, gynecomastia, libido decrease, petechiae, photosensitivity, urticaria, pruritus, fever, alopecia, hyperhidrosis, lushing, rash, increased urinary frequency 

      NORTRIPTYLINE BOXED WARNINGS: per PDR    

      Children, suicidal ideation

      The safety and efficacy of nortriptyline have not been established for the treatment of depression in adolescents or children less than 18 years of age. In October 2004, the FDA directed manufacturers of all antidepressants to include a boxed warning detailing the risk of suicide in pediatric patients. A causal role has been established for antidepressants in inducing suicidality in pediatric patients. The risk of suicidality for these drugs was identified in a pooled analysis of 24 placebo-controlled trials (n = 4,400) lasting up to 16 weeks in pediatric patients with major depressive disorder (MDD), obsessive compulsive disorder (OCD), or other psychiatric disorders. The analysis showed a greater risk of suicidality during the first few months of treatment in those receiving antidepressants (SSRIs and others). The average risk of such events on drug was 4% and 2% for placebo; however, no suicides occurred in these trials. Pooled analysis of short-term clinical trials during early phase treatment with SSRIs and other antidepressants in young adults (18 to 24 years) also showed an increased risk of suicidal thinking and behavior. The clinical need for an antidepressant in children or young adults for any use must be weighed against the risk of increased suicidality; patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior, particularly within the first few months of starting therapy or at the time of dose increase or decrease; such observation would generally include at least weekly face-to-face contact with patients during the first 4 weeks of treatment, then every other week visits for the next 4 weeks, then at 12 weeks, and as clinically indicated beyond 12 weeks; additional contact by telephone may be appropriate between visits. It is unknown if the suicidality risk in children and young adults extends to longer-term therapy (i.e., beyond several months). The possibility of a suicide attempt is inherent in patients with depressive symptoms, whether these occur in primary depression or in association with another primary psychiatric disorder. All patients with a history of suicidal ideation or behaviors and those with a prominence of suicidal ideation prior to treatment are considered at an increased risk for suicidal ideation or attempts, and should be closely monitored during treatment with nortriptyline. In patients who exhibit changes in symptoms, worsening of depression or suicidality, a decision should be made to change or discontinue treatment. If discontinuing, medication should be tapered as rapidly as possible, but with recognition that abrupt discontinuation can also cause adverse symptoms. All antidepressants should be prescribed in the smallest quantity consistent with good patient management in order to reduce the risk of overdose.    

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      NORTRIPTYLINE TECHNICAL DATA AND REFERENCES

       

      According to the FDA 

      Withdrawal Symptoms – Though these are not indicative of addiction, abrupt cessation of treatment after prolonged therapy may produce nausea, headache, and malaise.

      Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient’s presenting symptoms.

      Drugs Metabolized by P450 2D6 – The biochemical activity of the drug metabolizing isozyme cytochrome P450 2D6 (debrisoquin hydroxylase) is reduced in a subset of the Caucasian population (about 7% to 10% of Caucasians are so called “poor metabolizers”); reliable estimates of the prevalence of reduced P450 2D6 isozyme activity among Asian, African and other populations are not yet available. Poor metabolizers have higher than expected plasma concentrations of tricyclic antidepressants (TCAs) when given usual doses. Depending on the fraction of drug metabolized by P450 2D6, the increase in plasma concentration may be small, or quite large (8 fold increase in plasma AUC of the TCA).

      In addition, certain drugs inhibit the activity of this isozyme and make normal metabolizers resemble poor metabolizers. An individual who is stable on a given doseof TCA may become abruptly toxic when given one of these inhibiting drugs as concomitant therapy. The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.

      Withdrawal Symptoms After prolonged administration, abrupt cessation of treatment may produce nausea, headache, and malaise. Gradual dosage reduction has been reported to produce, within two weeks, transient symptoms including irritability, restlessness, and dream and sleep disturbance.  These symptoms are not indicative of addiction. Rare instances have been reported of mania or hypomania occurring within 2 to 7 days following cessation of chronic therapy with tricyclic antidepressants. 


      The extent to which SSRI TCA interactions may pose clinical problems will depend on the degree of inhibition and the pharmacokinetics of the SSRI involved. Nevertheless, caution is indicated in the co-administration of TCAs with any of the SSRIs and also in switching from one class to the other. Of particular importance, sufficient time must elapse before initiating TCA treatment in a patient being withdrawn from fluoxetine, given the long half-life of the parent and active metabolite (at least 5 weeks may be necessary).

      Concomitant use of tricyclic antidepressants with drugs that can inhibit cytochrome P450 2D6 may require lower doses than usually prescribed for either the tricyclic antidepressant or the other drug. Furthermore, whenever one of these other drugs is withdrawn from co-therapy, an increased dose of tricyclic antidepressant may be required. It is desirable to monitor TCA plasma levels whenever a TCA is going to be co-administered with another drug known to be an inhibitor of P450 2D6.

      REFERENCES

      [1] https://www.ncbi.nlm.nih.gov/books/NBK482214/ 

      [2]  https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983

      [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637660/ 

      [4] https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/nortriptyline

      [5] https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970

      [6] https://www.hindawi.com/journals/crips/2021/6647952/

      [7] https://www.medicalnewstoday.com/articles/amitriptyline-oral-tablet#side-effects

      [8] https://www.nswtag.org.au/wp-content/uploads/2018/06/1.4-Deprescribing-Guide-for-Tricyclic-Antidepressants-TCAs.pdf  

      [9] https://www.medsafe.govt.nz/profs/datasheet/n/nortriptylinenrimtab.pdf 

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      DISCLAIMER:

      *While great care has been taken in organizing and presenting the material throughout this website, please note that it is provided for informational purposes only and should not be taken as Medical Advice. 

      *The statements/info on this website have not been evaluated by the Food and Drug Administration (FDA). The products and labels mentioned / sold are not intended to diagnose, treat, cure, or prevent any disease or illness. 

      *The program outlined in Point of Return is not meant to substitute your doctor, instead it is to be utilized with Your physician to help you with your drug withdrawal process and with his or her consent throughout. 

      *This program is not meant to cure or prevent any disease or illness. 

      *Because prescription medications can cause severe withdrawal reactions, do not stop taking any medication without first consulting your physician. The decision to taper any medication should be discussed with your doctor and done with their consent and support throughout the process. More..