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Your doctor will likely start you on a low dose of nortriptyline and gradually increase your dose.

Before taking Pamelortell your doctor if you have used anSSRIantidepressant in the past 5 weekssuch as citalopramescitalopramfluoxetinefluvoxamineparoxetineor sertralineYou must wait at least 5 weeks after stopping fluoxetineProzacbefore you can take this medicine.

Your doctor will likely start you on a low dose of nortriptyline and gradually increase your dose.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicityThe risk increases if you are also taking other drugs that increase serotoninso tell your doctor or pharmacist of all the drugs you takesee Drug Interactions sectionGet medical help right away if you develop some of the following symptomsfast heartbeathallucinationsloss of coordinationsevere dizzinesssevere nausea/vomiting/diarrheatwitching musclesunexplained feverunusual agitation/restlessness.

Report any new or worsening symptoms to your doctorsuch asmood or behavior changesanxietypanic attackstrouble sleepingor if you feel impulsiveirritableagitatedhostileaggressiverestlesshyperactivementally or physicallymore depressedor have thoughts about suicide or hurting yourself.

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pamelor has been approved for adults ages 18 and over, but in some cases a doctor may prescribe the medication to someone younger.