去甲替林
【药品名称】去甲替林

【药物别名】去甲阿米替林、Nortrllen，Pamelor，Sensival

【英文名称】Nortriptyline

【剂    型】片剂：10mg；25mg。

【功用作用】为阿米替林的代谢产物，具有抗抑郁作用，起效快适用于伴有紧张，焦虑的抑郁症患者。亦可用于焦虑状态。

【用法用量】口服：10mg，每日3～4次。需要时可渐增至25mg，每日3次。青少年、老年人10mg，tid。

【注意事项】
（1）本品不良反应比丙米嗪少而且轻。常见有口干、嗜睡、便秘、视力模糊、排尿困难、心悸，偶见心律失常、眩晕、运动失调、癫痫样发作、体位性低血压、肝损伤及迟发性运动障碍。

（2）严重心脏病、青光眼及排尿困难者禁用。

Nortriptyline (Norpress)

Product: Norpress
Generic Name: Nortriptyline Hydrochloride
Category: Antidepressants >> Tricyclics
Other Names: Pamelor, Aventyl
Packaging Type: Packets of 100 x 10mg tablets
Manufacturer: Pacific Pharmaceuticals

100 Tablets of Nopress 10mg	US$22.00
200 Tablets of Nopress 10mg	US$40.00
300 Tablets of Nopress 10mg	US$57.00

Nortriptyline Description Norpress (Nortriptyline) is also called Pamelor or Aventyl. Norpress is a tricyclic antidepressant used to treat depression. It may also be used to treat chronic pain and other conditions as determined by your doctor. It works by stopping re-uptake of certain excitatory chemicals into brain cells. These chemicals then accumulate and are able to have a stimulatory effect on the brain. Nortriptyline Dosage The standard dosage of Nortriptyline in adults is 25mg three or four times daily. Dosage should begin at a low level and be increased as required. Side Effects of Nortriptyline Some side effects include, hypotension, hypertension, palpitations, hallucinations, disorientation, delusion, anxiety, restlessness, agitation, insomnia, panic, nightmares, dry mouth, blurred vision, constipation, urinary retention, skin rash, itching, photosensitization (avoid excessive exposure to sunlight), nausea and vomiting, anorexia, diarrhoea, abdominal cramps, increased or decreased libido, impotence, testicular swelling, breast enlargement, changes in blood sugar level, jaundice, hepatitis, weight changes, perspiration, flushing, drowsiness, dizziness, weakness, fatigue, headaches, alopoecia. Norpress may affect your ability to operate machinery and drive a car, make sure you know how this medication affects you before you carry out these actions. Precautions When Taking Nortriptyline Do not take Norpress in conjunction with a monoamine oxidase inhibitor (MAOI). This is known to cause convulsions and even death. Discontinue any MAOI抯 for at least 2 weeks before starting treatment with Norpress. Do not take this medication if you have history of heart disease, urinary retention, glaucoma, seizures, or thyroid problems. Consumption of alcohol should be done with caution as it could lead to increased suicidal attempts or overdosage. Advise your doctor if you wish to get pregnant or breast-feed.

相关链接：
去甲替林和舍曲林均对产后抑郁症安全、有效

根据一项随机化比较研究，两种抗抑郁药－三环类去甲替林和5-羟色胺选择性再摄取抑制剂舍曲林－对产后严重抑郁症有类似的良好功效。

美国匹兹堡大学医疗中心的Katherine L. Wisner博士及其同事在8月的《临床精神药理学杂志》（J Clin Psychopharmacol 2006;26.）上指出，曾经假设对非产妇严重抑郁症有效的抗抑郁药对产后严重抑郁症也有效。“我们的结果支持这个假设。” 他们使用去甲替林或舍曲林治疗109例产后严重抑郁症女性8周，并有16周的持续相，以评估反应的持续时间。

Wisner博士解释说：“在急性相，我们的目标是最大化抑郁症状的减轻。我们在8周的急性相中，使用舍曲林25 至200 mg/天和去甲替林10 至150 mg/天的剂量滴定方案。根据计划增加剂量，除非女性达到缓解标准或有禁止加量的不良反应。在109例接受治疗的女性中，95例在4周、83例在8周、29例在20周后提供了反应数据。

研究者报告，在研究的任何时间点，2个药物组发生反应或缓解的人数，以及至反应的时间没有显著差异。在4周时，46%的舍曲林治疗女性和56%的去甲替林治疗女性发生反应，缓解率两组分别为27% 和30%。在8周时，舍曲林治疗组和去甲替林治疗组发生反应分别为56%和69%，缓解率分别为46% 和48%。直到20至24周仍然参加研究的患者中，服用舍曲林的女性和服用去甲替林的女性反应率分别为93%和100%，缓解率分别为73%和79%。两个抗抑郁药物组的社会心理功能改善类似，在治疗攻击强迫观念的治疗方面，一种药物并不优于另一种药物。

Wisner博士说，两个药物组的总体不良反应类似，虽然个体不良反应谱不同。哺乳的母亲被包括在内，婴儿没有可观察到的不良反应，与其他文献报道的类似。