Effexor or amitriptyline/nortriptyline for MAV/VM -experiences and success stories , need some guidance!!

don’t wanna bore you guys but basically been on the horrid topamax for almost 5 months now it seems to work for a bit then again symptoms come back to be honest side effects are too much and I’m not seeing much of a benefit.

considering that Dr. Hain recommends effexor or ami/nortriptyline as first line I’d appreciate for those who’ve tried any to let me know if they’ve had any success with any? I’m so confused and dunno which one to start next

I heard effexor is difficult to wean off later even at small doses so was thinking of trying either one of the other 2 first but Dr Hain seems to recommend effexor much more highly but I’ve read alot of horror stories here about it

so confusing


I have been on 75 mg of nortriptyline since 2008 and was symptom free up until about 3 months ago. Side affects for me we’re weight gain…20 lbs and dry mouth. Tried very hard to keep the weight gain down but did gain regardless. My symptoms now are some vertigo but not the constant slow spinning I had before nortriptyline and a pretty constant migraine behind my eyes and light and noise sensitivity. My doctor has now added Verapamil and said that a lot of people are finding great relief from this drug. I will let you know how it works!

wow! that’s amazing success and even now the symptoms u describe are pretty mild I would assume compared to the constant MAV spins we all know and love lol
I’m still very concerned about trying either mainly because if the side effects. although I have quit topamax abd for the time being went back to propranol. interestingly enough I found a study online which basically found the propranolol (inderal) and effexor are EQUALLY AS EFFECTIVE but effexor is prescribed more for ppl witn depression. so yay !! sounds like good news as I read so many horror stories about effexor withdrawal and I was considering using ami aa ab add on (nortriptyline is unavailable here)

Propranolol and venlafaxine for vestibular migraine prophylaxis: A randomized controlled trial.Randomized controlled trial

Salviz M, et al. Laryngoscope. 2016.

Show full citation


OBJECTIVES/HYPOTHESIS: We compared the effectiveness of venlafaxine and propranolol for the prophylaxis of vestibular migraine (VM).

STUDY DESIGN: Prospective, randomized, controlled clinical trial.

METHODS: Sixty-four subjects with definite VM were enrolled. The subjects were randomly assigned to receive propranolol (group P, n = 33) or venlafaxine (group V, n = 31) for VM prophylaxis. Dizziness Handicap Inventory (DHI) scores, the Vertigo Severity Score (VSS), and the number of vertiginous attacks were recorded before and 4 months after treatment. The Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scores were also recorded to monitor the resolution of psychiatric symptoms.

RESULTS: At 4 months after treatment, the DHI total score decreased from 55.8 ± 2.7 to 31.3 ± 3.7 and from 50.9 ± 2.5 to 19.9 ± 2.9 (P < .001), the mean number of total vertiginous attacks decreased from 12.6 ± 1.8 to 1.9 ± 0.7 and from 12.2 ± 1.8 to 2.6 ± 1.1 (P < .001), and VSS decreased from 7.3 ± 0.3 to 2.1 ± 0.4 and from 7.9 ± 0.3 to 1.8 ± 0.5 (P < .001) in groups P and V, respectively. However, the treatment effects were similar in both groups (P > .05). BAI scores significantly decreased in both groups, whereas BDI scores decreased only in group V.

CONCLUSIONS: This study provided evidence that venlafaxine and propranolol show equal effectiveness as prophylactic drugs for ameliorating vertiginous symptoms in VM patients. However, venlafaxine may be superior to propranolol in ameliorating depressive symptoms.

© 2015 The American Laryngological, Rhinological and Otological Society, Inc.

PMID 26228645 [Indexed for MEDLINE]


So, there is such an animal then as ‘definite VM’. I fully intend to lie awake tonight wondering how they established that! It would be fascinating to know.

I believe they apply a diagnostic criteria which includes history of migraine, episodes lasting more than 48 hours, relation to migraine etc