The mechanism of mood elevation by tricyclic antidepressants is at present unknown. Pamelor® (nortriptyline HCl) is not a monoamine oxidase inhibitor. It inhibits the activity of such diverse agents as histamine, 5-hydroxytryptamine, and acetylcholine. It increases the pressor effect of norepinephrine but blocks the pressor response of phenethylamine. Studies suggest that Pamelor® (nortriptyline HCl) interferes with the transport, release, and storage of catecholamines. Operant conditioning techniques in rats and pigeons suggest that Pamelor® (nortriptyline HCl) has a combination of stimulant and depressant properties.

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