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Nortriptyline is an active metabolite of amitriptyline by demethylation in the liver. Chemically, it is a secondary amine dibenzocycloheptene and pharmacologically it is classed as a first-generation antidepressant. [36] Nortriptyline may also have a sleep-improving effect due to antagonism of the H 1 and 5-HT 2A receptors. [37]
ATC code N06 Psychoanaleptics is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products.
Nortriptyline (Pamelor, Aventyl) Noxiptiline (Agedal, Elronon, Nogedal) Pipofezine (Azafen/Azaphen) Protriptyline (Vivactil) Trimipramine (Surmontil) Opipramol (Insidon), tianeptine (Stablon, Coaxil) and amineptine (discontinued; formerly Survector, Maneon) are chemically TCAs but are pharmacodynamically atypical, and are therefore grouped ...
Nortriptyline reaches 10% higher level in the blood plasma than the parent drug amitriptyline and 40% greater area under the curve, and its action is an important part of the overall action of amitriptyline. [5] [9] Another active metabolite is (E)-10-hydroxynortriptyline, which is a norepinephrine uptake inhibitor four times weaker than ...
The TCAs are used primarily in the clinical treatment of mood disorders such as major depressive disorder (MDD), dysthymia, and treatment-resistant variants. They are also used in the treatment of a number of other medical disorders, including cyclic vomiting syndrome (CVS) and anxiety disorders such as generalized anxiety disorder (GAD), social phobia (SP) also known as social anxiety ...
Tricyclic antidepressants such as amitriptyline or nortriptyline and medications from the selective serotonin reuptake inhibitor (SSRI) group may improve overall symptoms and reduce pain. [7] Patient education and a good doctor–patient relationship are an important part of care.
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The second-generation antidepressants are a class of antidepressants characterized primarily by the era of their introduction, approximately coinciding with the 1970s and 1980s, rather than by their chemical structure or by their pharmacological effect.