Nortriptyline is a tricyclic antidepressant that effectively treats major depression, social anxiety and other psychiatric disorders. There are several factors that can affect the potency of the drug, such as the presence of grapefruit in the diet. Compounds in grapefruit might affect the potency of the drug and should be avoided.
Depression and Available Treatments
Major depression is a disorder affecting millions of Americans that is characterized by low self-esteem, low mood, loss of interest and potential suicide. There are many available antidepressants that have shown efficacy in treating depression, such as monoamine oxidase (MAO) inhibitors, selective seritonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. The tricyclic antidepressants are so named because they have three rings of atoms and include such compounds as imipramine, amitriptyline and nortriptyline. In addition to depression, tricyclic antidepressants are used to treat social anxiety disorder, bipolar disorder and obsessive-compulsive disorder.
Nortriptyline
One of the commonly prescribed tricyclic antidepressants is nortriptyline, marketed under the name Pamelor. The drug inhibits the reuptake of the stress hormone norepinephrine and the neurotransmitter serotonin. There are several possible side effects of nortriptyline, such as irregular heartbeat, dry mouth and constipation, but is generally regarded as a safe and effective treatment for depression. Nortriptyline also has been used as treatment for irritable bowel syndrome, migraines and bed-wetting in children, according to "Cochrane's Database for Systematic Review."
Drug Interactions of Grapefruit
Grapefruit contains several compounds that interact with many drugs. The flavanone compound naringin and the furanocoumarin compound bergamottin are known to interfere with enzymes in the small intestine and liver that affect drug metabolism, according to the "Journal of Clinical Pharmacology." Inhibition of these enzymes by the compounds found in grapefruit make the drug much less effective. The compounds are found in grapefruit juice as well as whole grapefruit. They are known to interfere with nortriptyline and a host of other drugs.
Avoiding Drug Interactions
To avoid drug interactions, it is important to discuss the drug with your doctor or pharmacist and thoroughly review the drug product insert. For patients taking nortriptyline, consultation with a doctor is recommended before altering the amount of grapefruit or grapefruit juice in the diet. The dosage or frequency also should not be altered without consulting your doctor. Alcohol consumption, excessive sun exposure, pain medication and muscle relaxers also might negatively affect the potency of nortriptyline.
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