Sorry to hear that you are a fellow sufferer but you are in good company here - you will get lots of support and plenty of good advice from the gang on here. If you read through the “wiki” section on the forum you will see that there are so many symptoms associated with the condition we all have and you will also prob know that many of us get different “names” put on our condition - be it MAV, PPPD, vestibular dysfunction, migraine variant etc however the important thing is irrespective of the NAME that’s given to your condition it is the same pool of drugs that are used to treat it. There is an excellent webpage you should look at by a Dr. Timothy Hain the top neuro in the US who is well respected for his success in treating the symptoms we have. He has a flowchart of meds for treating the symptoms and the sequence in which they can be tried.
Essentially the pool of drugs that people have success with is as follows:
Beta Blockers: eg half beta prograne extended release - these would be classed as a first line med to try. Allegedly these drugs work by smoothing blood vessels in the brain, they also help anxiety
Tricyclics Antidepressants: 2nd line meds such as Amitriptyline up to 30mg or Nortriptyline
SNRI: also classed as 2nd line meds eg Venlafaxine/Effexor extended release - highly recommended by Tim Hain for those of us that are dizzy - starting dose 37.5mg up to 225mg max dose. Wonderful for anxiety too, I am the calmest I have ever been in my 49 yrs
The drugs in these two buckets allegedly target serotonin levels in the brain
Then there are other classes of meds if the two above don’t work
Calcium channel blockers: Flunarizine or Verapamil
BP meds: Candesartan and some others I can’t think of
Anticonvulsants: Topamax - many find side effects intolerable, Gabapentin - awful drug for me, Sodium Valproate - equally awful
In my case I was treated by my GP and ENT for 3 months for supposed Vestibular Neuritis too - my symptoms were extreme and constant dizziness, ear pressure and head and face pressure. The dizziness was not a spinning dizziness it was more like a constant drunken imbalance and unsteadiness on my feet. I subsequently saw an audiologist, my VNG and caloric testing were all clear so she diagnosed PPPD. Six months later I was told by my neuro that In fact i have MAV, I was 46 at onset with no prior history and as time has gone on I know for sure it’s hormone driven. What I have come to understand is that the migraine plays havoc with the vestibular system so you have a ton of symptoms that you think are separate individual ailments but are actually all related. Believe me I almost lost my mind “trying to get to the bottom of it” - I saw an ENT, Endocrinologist, Rheumatologist, Audiologist, 3 x Neurologists, Otolaryngologist, Gynaecologist , Vestibular Rehabilitation Specialist and no doubt others along the way that I have forgotten about. I have only recently begun to get my symptoms under control after 3yrs of pure hell. In March I started on 37.5mg Venlafaxine extended release and am now at 150mg - this has been a total game changer in drastically reducing the constant dizziness and ear pressure and the anxiety is gone. Just 2 weeks ago my neuro added in 80mg extended release Half Beta Prograne to try to kill off the head and face pressure that’s still there and I am seeing further improvement. At my period I end up bad again with escalating dizziness and head pressure and so she has prescribed Frovatriptan for me to take to try to abort the migraine activity - supposedly Frova constricts the blood vessels in the brain which are causing the pain. So my current med regime is a beta blocker and an SNRI and then abortive meds at my period.
Many folks on here have had great success with Amitriptyline and I am sure they will chime in with their advice to help you through this.
There is light at the end of the tunnel, the challenge is to find a med or combo of meds that will get you symptom free. Some people are very lucky in that the first drug they try gets them to symptom free, Ami has a good track record for what we have so you are starting with a well tried one.
Hope this helps