Pamelor and Aventyl (nortriptyline) are tricyclic antidepressants used to treat depression. In multiple sclerosis, they are frequently used in lower doses to treat neuropathic or nerve pain in the arms and legs (burning sensations, pins and needles, stabbing pains) caused by damage to the pain-regulating pathways of the brain and spinal cord. The drug works by changing the way nerves react to pain in the central nervous system.
Nortriptyline comes in a tablet to be taken orally. It is usually taken one to four times a day, and should be taken at about the same time each day.
Common side effects of nortriptyline may include gastric disorders, mouth pain, unusual taste, black tongue, appetite or weight changes, urinating less than usual, itching or rash, breast swelling (in men or women), decreased sex drive, impotence, or difficulty having an orgasm.
These medicines also have a black box warning (information that appears on a prescription drug’s label and is designed to call attention to serious or life-threatening risks) concerning an increased risk of suicidal thinking and behavior in children, teenagers, and young adults with major depressive and other psychiatric disorders, especially during the first months of therapy or following changes in dosage.
Pamelor and Aventyl are brand names of nortriptyline. There are generic equivalents available.
Pain can have a significant impact on the quality of life of people with MS. A combination of positive changes in lifestyle (exercising and staying active, massages, chiropractic treatments, hydrotherapy, acupuncture) and medications can reduce the impact of pain on the quality of life in these patients.
The usual analgesics are usually not enough to ease the pain from nerves damage in the central nervous system, so drugs that treat seizures (phenytoin, gabapentin, carbamazepine) and antidepressants (amitriptyline, nortriptyline) and some benzodiazepines (clonazepam) are commonly first choices for pain management.
Read the latest news on pain management and multiple sclerosis here.