{"id":"nortriptyline-topiramate","safety":{"commonSideEffects":[{"rate":null,"effect":"Dry mouth"},{"rate":null,"effect":"Sedation"},{"rate":null,"effect":"Dizziness"},{"rate":null,"effect":"Cognitive impairment"},{"rate":null,"effect":"Weight changes"},{"rate":null,"effect":"Tremor"}]},"_chembl":null,"_dailymed":null,"mechanism":{"_ai_source":"claude-haiku-4.5","explanation":"Nortriptyline enhances monoaminergic neurotransmission by blocking reuptake of norepinephrine and serotonin, which modulates pain perception and mood. Topiramate acts through multiple mechanisms including voltage-gated sodium channel blockade, potentiation of GABA, and carbonic anhydrase inhibition, contributing to analgesic and mood-stabilizing effects. The combination leverages complementary mechanisms for enhanced efficacy in conditions like chronic pain and depression.","oneSentence":"This combination uses nortriptyline (a tricyclic antidepressant that inhibits norepinephrine and serotonin reuptake) together with topiramate (an anticonvulsant with multiple mechanisms including sodium channel blockade and carbonic anhydrase inhibition) to treat pain and mood disorders.","_ai_confidence":"medium"},"_scrapedAt":"2026-03-27T23:35:08.677Z","_scrapedBy":"cloudflare-swarm","_wikipedia":null,"indications":{"approved":[{"name":"Chronic pain conditions"},{"name":"Depression with comorbid pain"},{"name":"Migraine prophylaxis"}]},"trialDetails":[{"nctId":"NCT06799169","phase":"PHASE4","title":"Management of Acute Tinnitus With Migraine Medications","status":"ACTIVE_NOT_RECRUITING","sponsor":"University of California, Irvine","startDate":"2025-06-01","conditions":"Tinnitus","enrollment":100},{"nctId":"NCT05582837","phase":"PHASE4","title":"Treatment of Meniere's Disease With Migraine Medications","status":"RECRUITING","sponsor":"University of California, Irvine","startDate":"2022-08-01","conditions":"Ménière","enrollment":100},{"nctId":"NCT04404439","phase":"PHASE4","title":"Treatment of Tinnitus With Migraine Medications","status":"RECRUITING","sponsor":"University of California, Irvine","startDate":"2019-09-26","conditions":"Tinnitus, Subjective, Tinnitus","enrollment":150},{"nctId":"NCT02169830","phase":"NA","title":"Trial of Nortriptyline and Topiramate in the Initial Treatment of Vestibular Migraine","status":"TERMINATED","sponsor":"St. Louis University","startDate":"2014-08-22","conditions":"Migraine Disorders","enrollment":35},{"nctId":"NCT02374567","phase":"PHASE3","title":"Pharmacovigilance in Gerontopsychiatric Patients","status":"TERMINATED","sponsor":"Hannover Medical School","startDate":"2015-01","conditions":"Dementia, Depression, Schizophrenia","enrollment":407},{"nctId":"NCT00704860","phase":"PHASE4","title":"Treatment-Resistant Depression, Hippocampus Atrophy and Serotonin Genetic Polymorphism","status":"COMPLETED","sponsor":"University of Ottawa","startDate":"2005-02","conditions":"Major Depression","enrollment":27}],"_emaApprovals":[],"_faersSignals":[],"_approvalHistory":[],"publicationCount":2,"rwe":[],"genericFilers":[],"relatedDrugs":[],"labelChanges":[],"biosimilarFilings":[],"pricing":[],"formularyStatus":[],"manufacturing":[],"companionDiagnostics":[],"competitors":[],"timeline":[],"patents":[],"ownershipHistory":[],"trials":[],"biosimilars":[],"latestUpdates":[],"references":[],"tags":[],"ecosystem":[],"genericManufacturerList":[],"offLabel":[],"developmentCodes":[],"aliases":["Pamelor, Topamax"],"phase":"marketed","status":"active","brandName":"nortriptyline + topiramate","genericName":"nortriptyline + topiramate","companyName":"University of California, Irvine","companyId":"university-of-california-irvine","modality":"Small molecule","firstApprovalDate":"","aiSummary":"Nortriptyline + topiramate is being studied as a potential treatment for Ménière's disease, major depression, dementia, depression, and schizophrenia in clinical trials. Nortriptyline is a small molecule serotonin transporter inhibitor that works by inhibiting the sodium-dependent serotonin transporter.","enrichmentLevel":3,"visitCount":0,"trialStats":{"total":0,"withResults":0},"verificationStatus":"verified","dataCompleteness":{"mechanism":true,"indications":true,"safety":true,"trials":true,"score":4}}