Contraindications and Cautions with Liver and Kidney Disease (Drugs Are Detoxified)
Drug-drug interactions can occur by adding a drug that interferes with either the normal detoxification actions of the liver or with clearance via the kidney. However, the liver and kidneys should also figure into concerns for single drugs when either of them is compromised.
Drug-drug interactions occur in healthy patients because of clashes between different drugs, and single drug toxicity occurs in patients who are not healthy because of liver and/or kidney disease.
Drugs are cleared from the body by the enzymes of the liver changing them into substances that can be excreted by the kidneys via urine. The kidneys, besides partnering with the liver in this mission, can also primarily clear certain drugs on their own. The liver, to a lesser extent that the kidneys, can even clear some drugs on its own through excretion into bile that essentially transports these drugs into fecal matter ...
Nortriptyline is a prescription-only medication approved for the treatment of depression or major depressive disorder (MDD). It belongs to the group of second-generation tricyclic antidepressant (TCA). Just like most antidepressive agents in this group, nortriptyline starts to take effect around two weeks; however, significant therapeutic effects can take longer to achieve. Remission has been reported within 10–14 weeks using standard antidepressants. But 30% to 45% of treated patients will only experience modest effects, and a considerable number of patients will not have satisfactory improvement despite long-term therapy.
The challenges of antidepressant therapy
While there are other treatment modalities available for depression, antidepressant drugs remain the standard of care. There are many types of commercially available antidepressants that have shown excellent efficacy and safety profiles through the years. Yet, the use of pharmacological methods to treat depre ...