Nortriptyline Dosage: What You Need to Know About Strength, Timing, and Safety

When you're prescribed nortriptyline, a tricyclic antidepressant used to treat depression and certain types of chronic nerve pain. Also known as Aventyl, it works by balancing brain chemicals like serotonin and norepinephrine to improve mood and reduce pain signals. Unlike newer antidepressants, nortriptyline has been around for decades, and its dosage isn’t one-size-fits-all. What works for one person might be too low—or too high—for another.

Doctors usually start with a low dose, often 25 mg once a day, especially for older adults or people with liver issues. That’s because nortriptyline builds up slowly in your system, and going too fast can cause dizziness, dry mouth, or even heart rhythm changes. Over time, your dose might go up to 50–150 mg daily, split into one or two doses, depending on how your body responds. If you’re using it for nerve pain instead of depression, you might stay on the lower end—around 25–75 mg—since pain relief often happens at lower levels than full antidepressant effects. It’s not a quick fix either; it can take 2 to 6 weeks before you notice real changes, so patience matters.

One thing to remember: nortriptyline doesn’t work the same for everyone. Some people feel better with just 50 mg, while others need 100 mg or more. Blood tests can check your levels to make sure you’re in the safe, effective range—too little won’t help, too much can be dangerous. If you’re taking other meds, especially those for heart conditions, anxiety, or sleep, your doctor needs to know. Nortriptyline can interact with things like SSRIs, alcohol, or even some OTC cold pills. And never stop it cold turkey—tapering off slowly prevents withdrawal headaches, nausea, or mood crashes.

What you’ll find below are real, practical guides from people who’ve walked this path. You’ll see how nortriptyline compares to other tricyclics like amitriptyline, what side effects people actually deal with, how dosage changes affect sleep or energy, and why some folks switch to other meds after trying nortriptyline. Whether you’re just starting out or adjusting your current dose, these posts give you the no-fluff details you won’t get from a pharmacy label.