The Migraine Associated Vertigo Community
Read our welcome post, user support wiki & visit our member recommended products page

Efficacy of Venlafaxine, Flunarizine, and Valproic Acid

Some interesting points on Effexor from the below paper

  • In our study, venlafaxine can also decrease vertigo attack frequency and severity. We believe that venlafaxine confers some advantages over other medications for VM prophylaxis through several factors. Similar to the onset of migraine, 5-HT levels affect the onset of vestibular symptoms (24, 25). Venlafaxine decreases 5-HT levels and subsequently vertigo attack frequency and can also reduce the levels of certain inflammatory cytokines (2628) that play a role in episodic vertigo. Venlafaxine also exerts neuroprotection effects (29) that may decrease the severity of vertigo.

  • In our preliminary study, where we found that a daily dose of 37.5 mg had similar effects to the maximum daily dose of 75 mg. Therefore, we used 37.5 mg as the maximum daily dose in this study to further reduce side effects.

I had earlier posted about the findings of inflammatory cytokines in blood test in all patients with Vestibular migraine. Venlaflaxine helps with that.

I’ve read this paper in the past. Even have a feeling I may have posted it on here myself previously. It’s fascinating how the different drugs must work on MAV for I’m sure they must. Interesting Venlafaxine still doesn’t seem to be in anything like general use for MAV in the UK and where it is seems to come way down the preference list. When I saw the neurologist in October I specifically asked her about it and she was categoric it will not help migraine headaches. Strange really in retrospect. She went to great lengths telling me how treatment is all trial n error, there’s no way she could guess what would help any particular individual etc and whilst it appears she favours starting out with Topiramate or Amitriptyline, although previously she had told me Sodium Valproate was her favoured choice fir MAV, she was very firm that she wouldn’t prescribe Venlafaxine for MAV for that reason. I’ve noticed too Dr Hain writes he favours Venlafaxine for Visual Vertigo cases. I was also interested to note @Mav’s comment on another thread that despite being on 150mg Venlafaxine hadn’t addressed either her head pressure or nose pain. It’s all very interesting stuff. Wonder if it might be worth conducting a poll to see if @mav’s experience is general. Many people seem to improve on Venlafaxine but in what way is rarely mentioned other than the Visual aspect. Helen

1 Like

I am on effexor and it helps the entire spectrum of migraine symptoms not just visual.

1 Like

So it’s reduced frequency, duration and severity of headache and reduced vestibular/vertigo attacks as well. Great news. How’s you doing with head pressure and the unbalanced feelings on it or weren’t they issues for you.

My 3Es of VM management

Eating right



I have been on it for 3 weeks. I haven’t reached 37.5 yet. I do know that my balance is much improved. When I walk I don’t vier off in either direction much at all. I feel the ground under my feet now Nothing much else to report as I just started the med.

Don’t seem to be an answer to my question.

Yes Helen effexor helped with all of your above mentioned symptoms. The longer you take it, the better it works. It works even better when combined with the 3Es. I have launched out of a migraine head just by using a 60 minute workout versus a abortive. I learnt this trick from Em aka @flutters

I am not symptom free to post a success story as I am sure you will understand.


Delighted for you and surprised as it doesn’t seem to have done likewise for the ladies taking it which is interesting in itself in that it makes me even more convinced there’s more going on here.

No not a success story. I understand, I’d have expected selfies of you and flags on the Empire State Building in that case.

1 Like

Looking forward to those :wink: :office:

I second this! I used to fill in my sumatriptans once a month. Since starting venlafaxine in August I’ve only filled it once and that was just last week!!! Yes I do still get headaches but the severity and duration are definitely not as bad as they use to be. Now I can just wait it own while applying ice or take 600mg of ibuprofen which in the past would be a complete joke!


Not true…there are ladies who ramp upto 150mg unlike me on a minimal dose and they do well…check the latest update from Amylouise and she is on effexor as well

I have read many women on effexor success stories on other groups as well. I dont think the relief is limited to men. Are you considering it as an add on to your propranolol?

70% at 100mg is great progress, but hardly the silver bullet?

1 Like

No hardly, not after two years of being chronic (following being a migraineur from very young) and in one otherwise so young, fit and healthy. Of course Amy did suffer tremendously from the resultant anxiety which I think at those extreme levels is really PTSD- type stuff. That certainly would hold a person back. Also I wonder how much credit should go to the Effexor and how much to other environmental changes. On the plus side I imagine things would have improved dramatically for her following her anticipated move to The States last Autumn into a new home with her supportive partner. Coping on one’s own really must be the pits. The positive move, which I assume went ahead mainly because Amy’s not been a regular poster on here for months so must have been receiving emotional support elsewhere, should have aided recovery. Just maybe she’s actually better than 70%. Hard as it may seem to grasp but just sometimes I think even percentages can prove misleading. My statistics master at school has just turned in his grave! Helen


Comparing the video of Amy this year and 1 year ago, night and flipping day, but only she truly knows how much she’s improved of course. She looks 30% a year ago and 75% now from observation only.

But as you say, once you start to ‘cope’ (get rid of the bulk of the anxiety and PTSD we all get initially) the symptoms hit your sense of well-being so much less even though they still nag you.

And there’s @mav, @jojo65 and @nin who don’t seem to have been able to persuade it to control that RHP which is the migraineous stuff. Oh I’m sure many many others have. Dr Hain certainly rates it. I guess that’s why many end up on combos or more. I consider it that’s why I ran it past the neuro but she was having none of it. My GP would agree to 37.5mg absolute maximum as I have contra indicators for it. So it stays in the packet.

1 Like

Venlafaxine combined with propranolol has been a real game changer for me, I’m currently on 150 ER venlafaxine and 120mg ER propranolol for over a year and have to say I’m about 95%, I exercise as well which really helps but, I only avoid red wine and egg whites. My neuro said once we have 6 month being symptom free we can look to educe my meds which would be great as I really struggle to lose weight on them despite training and eating well.


For what its worth, the 2nd neuro I saw was a well-known one on Harley St. He’s seen as a kinda progressive doctor in the London circle. First med he put me on was Effexor 37.5mg to be built up to I think 75mg in 2 weeks.

Anyway, I found him to be a terrible doctor and the Effexor didnt work on me - had to stop it after 1 day. Not a helpful post but just thought I’d share

Let me guess. You collected your prescription, went home and took one 37.5mg pill straight off the first and only time?

I was just about to say far too much for a MAV sufferer bearing in mind they are nearly always ultra med sensitive but a while ago I happened on a website of people taking Venlafaxine for depression etc and there were numerous posts expressing all the start up/increase difficulties they’d experienced too!

Cant remember exactly but I think one. Woke up the next day so dizzy that i couldnt stand, my legs were 100% numb and jelly-like, and I couldnt walk.

I can understand and accept side effects like dry mouth, insomnia, some dizziness/headache etc. but not being able to walk crosses the cost/benefit threshold in my opinion. Theres no way I could have gone to work on Effexor - if I were to carry on with it, I probably would have had to quit work for 1 month.

My GP referred me to the neuro as it was his “friend” and the neuro saw me for 15 mins and sent me home straight away with Effexor and told me to come back in 4 weeks (so he can get another £300 pay day). As I didnt go back to the neuro for a 2nd appointment my GP turned from a super engaged/caring guy into a cold/disengaged GP - I suspect my GP probably got commision from my referral to the neuro. And the neuro gets money from big Pharma for selling more antidepressants (Effexor is all the rage at the moment).

Anyway, going to see Dr Nandi tomorrow at the London Balance & Hearing clinic (same doctor as AmyLouise I believe?). All the doctors there do a mixture of NHS & private so im inclined to hope that they genuinely hold a patients best interests at heart. Its headed up by Professor Luxon (as you probably know), so couldnt think of anywhere better to go. Hopefully something positive comes out of it tomorrow!

1 Like