How Long Does Nortriptyline Take to Work?

When you start taking nortriptyline, a tricyclic antidepressant used to treat depression, anxiety, and chronic pain. Also known as Aventyl or Pamelor, it doesn’t work like a quick fix—your body needs time to adjust. Many people expect to feel better right away, but that’s not how most antidepressants operate. For nortriptyline, it usually takes 2 to 4 weeks before you notice any real change in mood or energy. Some folks might feel a little better after 10 to 14 days, but full effects often take up to 6 to 8 weeks. If you stop too early because you don’t see results, you might miss out on the full benefit.

This delay isn’t unique to nortriptyline. It’s true for most tricyclic antidepressants, a class of older but still effective medications that affect serotonin and norepinephrine in the brain. Unlike stimulants, these drugs don’t boost your mood instantly—they help rewire how your brain responds to stress and sadness over time. You might notice small shifts first: better sleep, less irritability, or more appetite. These are often signs the medicine is starting to work, even if your sadness hasn’t vanished yet.

Side effects can show up sooner than the benefits. Dry mouth, drowsiness, blurred vision, or constipation are common in the first week or two. These usually fade as your body gets used to the drug. If they’re too intense, talk to your doctor—your dose might need adjusting. Don’t assume you’re not responding to the medicine just because you feel worse at first. That’s part of the process for many people.

What affects how fast nortriptyline works? Your metabolism, age, other medications you’re on, and even your liver function play a role. Some people break it down quickly and need higher doses. Others process it slowly and feel effects faster—or with more side effects. That’s why doctors start low and go slow. It’s not one-size-fits-all.

And while nortriptyline is often prescribed for depression, it’s also used off-label for nerve pain, migraines, and even bedwetting in kids. The timeline for pain relief can be different than for mood—it sometimes kicks in faster, within 1 to 2 weeks. But again, patience matters. This isn’t a drug you take for a few days and call it quits.

If you’ve been on nortriptyline for over two months and still feel nothing, it’s time to talk to your doctor. Maybe it’s not the right fit for you. There are other options—like SSRIs, SNRIs, or newer tricyclics—that might work better with fewer side effects. But if you’ve stuck with it through the rough first weeks, you might be on the verge of a real improvement.

Below, you’ll find real-world insights from people who’ve taken nortriptyline, comparisons with other antidepressants like amitriptyline, and practical advice on managing the wait. You’re not alone in this. Many have walked this path—and found their way through.