Nortriptyline is a tricyclic antidepressant first introduced in the early 1960s as the primary active metabolite of amitriptyline, developed to provide similar therapeutic benefits with a potentially improved side-effect profile. It works mainly by inhibiting the reuptake of norepinephrine (and to a lesser extent serotonin), thereby increasing the availability of these neurotransmitters in the central nervous system. Initially approved for major depressive disorder, nortriptyline later gained additional uses, including treatment of neuropathic pain, smoking cessation support, and prevention of chronic migraines. Its long clinical history and extensive research have established it as a reliable second-generation tricyclic antidepressant still used today when modern alternatives are ineffective or not tolerated.
