Is Pamelor measurable in the blood, and is this important?

Pamelor (generic name: nortriptyline) helps the brain increase norepinephrine at low doses and serotonin at medium doses. It is licensed for depression and is sometimes prescribed for migraine and chronic pain. There are reports that Pamelor can reduce ringing in the ears (tinnitus).

Unlike most antidepressants, there is a laboratory blood test that can show how much Pamelor is in your bloodstream. However, the amount of Pamelor in your blood cannot determine whether you need more or less Pamelor to help with your depression; only you and your doctor can tell that.

Side effects include the usual tricyclic suspects like dry eyes, dry mouth, dry mucous membranes, low blood pressure when standing (postural hypotension), constipation, and difficulty urinating. Pamelor reaches a peak in your bloodstream eight hours after you take it and stays in your body four days after your last dose. It comes in 10-, 25-, and 50-milligram capsules. Pamelor doses are about one-half the usual doses for other tricyclic antidepressants, starting at 25 milligrams and increasing to 100 milligrams. The usual maximum dose is 150 milligrams.

Other than the laboratory test, most patients have not found any particular advantages of Pamelor over the most effective tricyclic antidepressants.