Nortriptyline, sold under the brand name Pamelor, among others, is a medication used to treat depression, neuropathic pain, attention deficit hyperactivity disorder, stopping smoking and anxiety. It does not appear to be useful for young people with depression. Nortriptyline is a less preferred treatment for stopping smoking, it is taken by mouth. Common side effects include dry mouth, blurry vision, low blood pressure with standing, weakness. Serious side effects may include seizures, an increased risk of suicide in those less than 25 years of age, urinary retention, mania, a number of heart issues. Nortriptyline may cause problems. Use during breastfeeding appears to be safe, it is a tricyclic antidepressant and is believed to work by altering levels of serotonin and norepinephrine. Nortriptyline was approved for medical use in the United States in 1964, it is available as a generic medication. A month supply in the United Kingdom costs the NHS about £25.00 as of 2019. In the United States the wholesale cost of this amount is about US$4.20.
In 2016, it was the 192nd most prescribed medication in the United States, with more than 3.1 million prescriptions. Nortriptyline is used to treat depression; this medication is in capsule or liquid and is taken by the mouth one to four times a day, with or without food. People are started on a low dose and it is increased. A level between 50-150 ng/mL of nortriptyline in the blood corresponds with an antidepressant effect. In the United Kingdom, it may be used for treating nocturnal enuresis, with courses of treatment lasting no more than three months, it is used off-label for the treatment of panic disorder, irritable bowel syndrome, migraine prophylaxis and chronic pain or neuralgia modification temporomandibular joint disorder. Although not approved by the FDA for neuropathic pain, many randomized controlled trials have demonstrated the effectiveness of TCAs for the treatment of this condition in both depressed and non-depressed individuals. In 2010, an evidence-based guideline sponsored by the International Association for the Study of Pain recommended nortriptyline as a first-line medication for neuropathic pain.
However, in a 2015 Cochrane systematic review the authors did not recommend nortriptyline as a first-line agent for neuropathic pain. Nortriptyline should not be used in the acute recovery phase after myocardial infarction. Use of tricyclic antidepressants along with a monoamine oxidase inhibitor, IV methylene blue are contraindicated as it can cause an increased risk of developing serotonin syndrome. Closer monitoring is required for those with a history of cardiovascular disease, glaucoma, or seizures, as well as in persons with hyperthyroidism or receiving thyroid hormones; the most common side effects include dry mouth, constipation, increased appetite, blurred vision and tinnitus. An occasional side effect is a irregular heartbeat. Alcohol may exacerbate some of its side effects; the symptoms and the treatment of an overdose are the same as for the other TCAs, including serotonin syndrome and adverse cardiac effects. Because TCAs have a narrow therapeutic index, the likelihood of serious overdose is high.
A nortriptyline overdose is considered a medical emergency and results in death. Symptoms of overdose include: irregular heartbeat, coma, hallucination, widened pupils, agitation, low body temperature, stiff muscles and vomiting. Excessive consumption of alcohol in combination with nortriptyline therapy may have a potentiating effect, which may lead to the danger of increased suicidal attempts or overdosage in patients with histories of emotional disturbances or suicidal ideation, it may interact with the following drugs: heart rhythm medications such as flecainide, propafenone, or quinidine cimetidine guanethidine reserpine Nortriptyline is an active metabolite of amitriptyline by demethylation in the liver. Its pharmacologic profile is. Chemically, it is a secondary amine dibenzocycloheptene and pharmacologically it is classed as a first-generation antidepressant; these effects account for some therapeutic actions as well as for most side effects such as sedation, anticholinergic effects, etc.
Nortriptyline may have a sleep-improving effect due to antagonism of the H1 and 5-HT2A receptors. In the short term, nortriptyline may disturb sleep due to its activating effect. In one study of long-term efficacy, nortriptyline showed a higher relapse rate in comparison with phenelzine in individuals being treated for depression due to the toxic metabolite 10-hydroxynortriptyline being produced; the authors of a review noted. In one study, nortriptyline had the highest affinity for the dopamine transporter among the TCAs besides amineptine, although its affinity for this transporter was still 261- and 63-fold lower than for the norepinephrine and serotonin transporters. Nortriptyline is metabolized in the liver by the hepatic enzyme CYP2D6, genetic variations within the gene coding for this enzyme can affect its metabolism, leading to changes in the concentrations of the drug in the body. Increased concentrations of nortriptyline may increase the risk for side effects, including anticholinergic and nervous system adverse effects, while decreased concentrations may reduce
Zarbofoot, is an Iranian musical band, active since 2017. Zarbofoot was formed by Dariush Salehpour and Amir Mohammadi in the spring of 2017, was joined by the other members including Reza Tajbakhsh; the band comprises a spectrum of wind instruments and electronic music with a touch of jazz and impromptu performance. The themes of the band's music are worldwide and social. Zarbofoot gave its debut concert on 1 December 2018 at Niavaran Cultural House on the occasion of World AIDS Day with the collaboration of the United Nations and UNAIDS in Iran, an electrojazz performance; the name "Zarbofoot" is in fact an exaggerated Persian equivalent for the English words "saxophone" and "beat". Zarbofoot has five main players: Dariush Salehpur, electronic instruments Reza Tajbakhsh, piano Alireza Miragha, trumpet Soroush Omoumi and percussion Amir Mohammadi and clarinet The band have collaborated with some famous singers, among them: Salar Aghili, Mohsen Yeganeh, Homayoun Shajarian, Farzad Farzin, Benyamin Bahadori.
Plastic Garden, released 14 November 2019"Walking in the Rain", electrojazz, 2017 "Plastic garden", electrojazz, 2018The album and both songs' composer and mixer is Dariush Salehpour. Dariush Salehpour Zarbofoot on Facebook Zarbofoot on Instagram Official website www.bia2.com Zarbofoot www.bia2.com Plastic Garden by Zarbofoot
Ignacio Mieres is an Argentine rugby union player. He played for Worcester Warriors in the RFU Championship Mieres was signed on trials for Leicester Tigers in March 2008. After only being able to play sevens for the Tigers, Loffreda got sacked from Leicester and Mieres decided to move forward, it was when he decided to move to Stade Francais, where he wasn't able to play because of his Argentinean passport, Stade Francais having two foreign players and Gasnier. Mieres spent 4 months there; the next season, he returned to Stade Francais, where he played 10 matches in the Top 14 and Heineken Cup. When the season finished, Mieres was released and went back to Argentina, where he played for the Pampas for a couple of months before moving to Exeter Chiefs, he started his career at Exeter as the third choice fly-half, after waiting a couple of months, he started the last two games of the Premiership scoring 25 points. For 2011/2012 Mieres was picked as the first-choice number 10 for the Chiefs scoring over 270 points across Premiership and Amlin Challenge Cup matches.
After having an outstanding season, qualifying for Heineken Cup and being picked as the player of the season, he signed a two-year contract with Exeter, is waiting for his chance in the Argentina "Pumas" team. It was announced on 6 February 2013 that at the conclusion of the season Mieres will be joining Worcester Warriors, he kicks post, is able to play at fly-half, centre or full back