Do I have MAV?

About three years ago I was at work and suddenly was hit by a dizzy spell where I felt like I was going to pass out. Ever since then I have not felt the same. My vision is off, I get tension headaches and a constant off balance/lightheaded feeling. Accompained by fatigue and a heavy head.

The first thing my doctor did when I went to him was prescribe sertraline. I started taking it and the symptoms gradually lessened, so I (stupidly) just stopped taking the sertraline. I was fine for months and then everything started to come back, much worse headaches and worse lightheadedness too aswell as my vision being off.

I went back to the doctor he gave me nortrtiptyline 10mg for the head pain and overnight it went away, leaving me with background tension headaches and the lightheadedness still.

I went back to the doctor again and was put back on sertraline 100mg again, but it made no difference this time around - could it have lost it’s effectiveness 2nd time round? Although I may not have given it long enough - 2/3 weeks.

I’ve tried everything else - accupuncture, hynotherapy, chiropractor, deep tissue massage on my neck, botox, cutting out wheat, sugar, dairy, caffeine, cheese, chocolate and citrus (the last four seem to help slightly).

I’ve also had ct scans, mris and vestibular testing which all came back normal. My hearing is fine.

My last trip to the doctors resulted in being described Seroxatine (Paxil) which is a more heavy duty AD than sertraline. First few days on it were absolutely awful, much worse dizziness, blurred vision etc so I dropped my dose from 20m to 10mg and I’m feeling back to normal (for me).

My questions to the people on this forum, which I have been reading for a long time are:

  1. Do I definitely have MAV if I’ve never had spinning vertigo or rocking sensation? I just feel lightheaded alot and when I move my head quickly I get woozy (tried epely manouvre and doesnt help)

  2. Does the fact that I have a family history of migraine (my mum, auntys and nan all suffer terribly but nothing constant like this) make it more likely to be MAV?

  3. Should I up my dose of nortriptyline to try and get rid of the background headache?

  4. Is Paxil worth staying on or should I give sertraline another go?

  5. I’m going to my neurologist tonight… is there something he could add to the mix to take the dizziness away? Verapamil?

Thank you so much in advance for your help and sorry for the essay! I know how hard it is living with this bs and appreciate your time.


Do you have any problem with your balance/walking? How long were you on the sertaline the first time? Did it make you feel 100% better, how long did it take to kick in?

From reading on here (and from my own experience), it is common that a med that worked the first time around may not work the 2nd time (or not work as well)- so that may be the case with sertaline. That is good you feel better on the smaller dose of paxil, the larger was prob just too much for you at first.

I think you can have mav if you dont have spinning or rocking-there are a lot of different manifestations of it.

Was the Dr. who put you on sertaline a neurologist, or a gp? I guess if I were you I would try to up the nortriptiline first before adding another med??? Or are you supposed to stay on paxil??? If you already tried sertaliine for a 2nd time and it didnt work, I wouldn’t try it again.

Thanks for your reply.

I was on the sertraline the first time for 6 months or so. It made me feel well to the point where I decided I had got better and didn’t need the meds anymore, but hadn’t been warned about stopping them suddenly. I was only 21 at the time and didn’t know about all this stuff! It was a neurologist that prescribed the sertraline.

Interestingly I went back to my neurologist on Tuesday and he told me that my most recent MRI which I asked them to repeat for peace of mind showed up something ‘not abnormal but different’ and I need to have a closer scan of my pineal gland - having googled this it seems that people with enlarged glands or cysts or even tumours (which I’m sure it isn’t) have balance and headache issues. It’s something that was reported as ‘incidental’ on my previous MRIs, so when I have the results from my scan things will be much more clear. In the meantime I’m going to up the nortriptyline dose next week and carry on with the Paxil.

Thanks for your help!

Sarah x