Healthy pregnancy hub

Nortriptyline (e.g. Aventyl®)

Last Update: 03 Jul 2026

Medication
Welcome to our fact sheet on nortriptyline during pregnancy and lactation. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

The HEALTHY PREGNANCY HUB team is collaborating with MotherToBaby to share information on this topic. The original version is available here (March 2024).

Serene, our chatbot, can also answer your questions about medications during pregnancy.

Please note that this fact sheet is based on United States information and has been adapted for Canada, with a review by our Canadian experts. Minor differences may exist between the two countries. Always consult your healthcare professional for information tailored to your situation.

1. What is nortriptyline?

Nortriptyline is a medication that has been used to treat depression, attention deficit hyperactivity disorder (ADHD), eating disorders, irritable bowel syndrome, migraines, and pain. It belongs to a class of medications called tricyclic antidepressants. Some brand names for nortriptyline are Aventyl® and, in the United States, Pamelor®. 

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Some people may have a return of their symptoms (relapse) if they stop this medication during pregnancy. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

Pregnancy might affect how some people break down this medication. If so, changes to their medication doses might be needed during pregnancy. Your healthcare provider can discuss this with you, if necessary. 

2. What does research say about the safety during pregnancy?

I take nortriptyline. Can it make it harder for me to get pregnant?

It is not known if nortriptyline can make it harder to get pregnant.

Does taking nortriptyline increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if nortriptyline can increase the chance of miscarriage. However, depression itself might increase the chance of miscarriage. More information on depression can be found in our fact sheet here. 

Does taking nortriptyline increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. Information on the use of nortriptyline in pregnancy is limited. A small number of studies have not found a higher chance of birth defects with doses of nortriptyline used for treatment of depression. 

Does taking nortriptyline in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if nortriptyline can increase the chance of pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). One study found that use of other tricyclic antidepressants (not nortriptyline) might increase the chance of preterm delivery or low birth weight. However, research has shown that untreated depression during pregnancy can increase the chance of pregnancy complications. This makes it hard to know if it is the medication, untreated depression, or other factors that might increase the chance for these problems. 

I need to take nortriptyline throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of other tricyclic antidepressants (not nortriptyline) during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal and can include colic (crying a lot), cyanosis (skin looks blue), breathing problems, and irritability. In most cases the symptoms go away in a few days without long-term health effects. Not all babies exposed to tricyclic antidepressants will have these symptoms. It is important that your healthcare providers know you are taking nortriptyline so that if symptoms occur your baby can get the care that is best for them. 

Does taking nortriptyline in pregnancy affect future behavior or learning for the child?

It is not known if taking nortriptyline in pregnancy can affect future behavior and learning for the child. Reports of 11 children who were exposed to nortriptyline in pregnancy showed no differences in IQ, language, or behavior compared to children exposed to a different antidepressant or children who were not exposed to antidepressants during pregnancy. More research is needed to confirm.

3. Lactating while taking nortriptyline

Nortriptyline passes into human milk in small amounts. A limited number of cases have reported no side effects or negative effects on infant growth and development. The benefit of continuing nortriptyline while breast/chestfeeding (or pumping) might outweigh the risks of an untreated mental health condition. Your healthcare provider can talk with you about nortriptyline and what treatment is best for you.

4. What about fathers and sperm donors?

If a male takes nortriptyline, could it affect fertility or increase the chance of birth defects?

Some studies suggest that nortriptyline might lower sex drive (desire to have sex) and increase the chance of sexual dysfunction (problems during any stage of typical sexual activity). This could affect a male’s fertility (ability to get a person pregnant). However, depression might also affect a male’s fertility. It is not known if nortriptyline could increase the chance of birth defects. In general, exposures that fathers and sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures here.

Key points

  • Nortriptyline is an antidepressant used to treat depression, ADHD, migraines, and certain types of pain.
  • It is not known whether nortriptyline increases the risk of miscarriage, preterm birth, or having a baby with low birth weight. Depression itself may also increase these risks.
  • Available studies have not shown an increased risk of birth defects when nortriptyline is used to treat depression.
  • Nortriptyline may cause temporary symptoms in some newborns shortly after birth (such as excessive crying, irritability, or breathing difficulties), but, if they appear, these symptoms usually go away within a few days.  
  • Nortriptyline passes into breast milk in small amounts.
  • In males, nortriptyline may lower sexual desire or cause sexual dysfunction, but the risks to a pregnancy remain low.
  • Always talk with a healthcare professional before changing or stopping any medication. 

References

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Disclaimer

HEALTHY PREGNANCY HUB provides a source of information validated by health professionals; however, this information is provided for informational purposes only and should not replace professional advice. Medical standards and practices evolve as new data becomes available, so it is imperative to consult your doctor or a qualified health professional for any questions or concerns regarding your health without delay or omission. It is the responsibility of your treating physician or any other health professional, based on their independent experience and knowledge of the patient, to determine the best way to evaluate and treat you.

HEALTHY PREGNANCY HUB does not specifically recommend or endorse any test, practitioner, treatment, product, or opinion mentioned on our platform. HEALTHY PREGNANCY HUB also does not replace the individual patient assessment based on the examination by the healthcare provider of each patient and the consideration of laboratory data and other patient-specific factors.

The use of the information available on our site is at your own risk. No person involved in the creation, production, promotion, or marketing of HEALTHY PREGNANCY HUB guarantees or represents, expressly or implicitly, anything regarding the information available on the platform, which is provided “as it is”. All warranties are expressly excluded and disclaimed, including but not limited to implied warranties of merchantability or fitness for a particular purpose, as well as any warranties arising by law or otherwise in law or from trade or usage. Any statements or representations made by any other person or entity are void.

While consulting symptoms or other medical information on our platform may guide your discussions with your healthcare professional, this information should not be used to make a medical diagnosis or determine treatment. Before making changes to your supplement or medication regimen, please discuss with your medical team or contact 811 (Canada) to ensure the relevance of these changes to your individual situation.

Credits
MotherToBaby
Organization of Teratology Information Specialists (OTIS)
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Sherif Eltonsy
University of Manitoba
Modupe Tunde-Byass
University of Toronto
Laurie Beauvilliers
Université de Montréal
Émy Roberge
Centre hospitalier universitaire Sainte-Justine

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