nortriptyline

n. a tricyclic antidepressant, a so-called secondary tricyclic, that is the principal metabolic product of amitriptyline. Although its clinical efficacy is the same as other tricyclics, nortriptyline and the other secondary tricyclic agent, desipramine, were often preferred because they are less sedating and have fewer anticholinergic effects. A therapeutic window is thought to exist for nortriptyline: Although plasma levels do not always correlate with clinical effectiveness, optimum responses are thought to occur when serum levels of the drug are between 50 and 150 ng/ml. Plasma levels over 500 ng/ml are toxic. The availability of newer antidepressants that do not require therapeutic monitoring has led to a decline in its use. U.S. trade names: Aventyl; Pamelor.

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Psychology term of the day

January 11th 2025

polypharmacy

n. the simultaneous use of a variety of drugs of the same or different classes with the intent of producing a more robust therapeutic response. Polypharmacy for mental disorders may, for example, involve the administration of two or more antidepressants in the hope that agents with different mechanisms of action will produce greater clinical improvement than that seen with any one drug alone. Polypharmacy is often criticized because of the lack of well-controlled studies supporting its use and the greater likelihood of adverse drug interactions when two or more drugs are used simultaneously. However, for those individuals unsuccessfully treated with several trials of monotherapy, or for whom monotherapy achieves suboptimal results, polypharmacy may be therapeutically indicated and appropriately managed.