What the FDA labels say about taking them together
Lithium and nortriptyline
Nortriptyline's FDA label of December 4, 2024 names lithium in its warnings section; lithium's label does not name nortriptyline itself but warns about its class (Tricyclic antidepressants). The nortriptyline label: “Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including Pamelor, alone but particularly with concomitant use of other serotonergic drugs …”
Check it at the source: the lithium FDA label on DailyMed (effective December 23, 2025, Glenmark Pharmaceuticals Inc., USA); the nortriptyline FDA label on DailyMed (effective December 4, 2024).
What does the lithium label say about nortriptyline?
Lithium's label does not name nortriptyline itself; it warns about its class (Tricyclic antidepressants):
Lithium label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, triptans, tricyclic antidepressants, fentanyl, tramadol, tryptophan, buspirone, and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Drug Interactions ( 7.1 )].
Source: FDA drug label (Lithium Carbonate), Glenmark Pharmaceuticals Inc., USA, effective December 23, 2025 (SPL set 63b3790f-a9b5-47f4-bae1-ddf8b43c13c1), via openFDA; the full label on DailyMed
What does the nortriptyline label say about lithium?
Nortriptyline label, warningsSerotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including Pamelor, alone but particularly with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s Wort) and with drugs that impair metabolism of serotonin (in particular, MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue).
Source: FDA drug label (PAMELOR), SpecGx LLC, effective December 4, 2024 (SPL set e17dc299-f52d-414d-ab6e-e809bd6f8acb), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Lithium | Nortriptyline | |
|---|---|---|
| Labeled for | Bipolar disorder | Depression |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.104 per capsule 300 mg capsule | $0.113 per capsule 10 mg capsule |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once