How long does it take for nortriptyline to work

. . . and how will I know when it finally does?

I’ve been on it for two weeks and so far the only thing that has changed is that I only get about 4 hours of sleep a night. I thought it was getting better but last night I woke up at 11:00 and finally at 2:00 I took half a valium, and finally fell asleep around 3:00. I so much don’t want to take valium because I want to see how my body will fare without that or meclizine but getting by on 1 or 2 hours of sleep is too painful to even think about. In the past I have had insominia but always, after 1 or 2 nights or at the most 3 nights of little sleep I will get a good night of very deep sleep and then things are okay for a few weeks until I have another couple of nights. But after 2 weeks of this I am starting to feel very depressed and crabby and angry and very worried about how I will make it through 9 hours of work today.

I keep taking the stuff because I’m thinking it has to get better sometime, but will it? And if it does eventually take away the constant feeling of motion sickness and the occassional attacks of vertigo then it may be worth it. But back to my original question, how long does it take for it to start working? Should I have felt a different by now? Since I feel so lousy from lack of sleep how will I ever know if it is working. This is really the last chance drug for me - the others are out for one reason or another so I want to give this a try for as long as I can.

I think it takes around 2-4 weeks to work. The insomnia usually (but not always) passes but it can take 4 weeks or so I think.

Have you tried amitriptyline instead? Nortriptyline is a metabolite of amitriptyline, but ami has some other stuff as well and generally is less prone to cause insomnia (altough it did for me at first)

it can take several weeks to work at the point that you are on a therapeutic dose. if I am remembering correctly, you aren’t anywhere near that. My doc told me that I will likely not experience any effects until 50-60 and then you might have to increase further to 100 or more. so, you’re definitely jumping the gun in wanting to see effects so soon. My doc also likes to titrate very slowly. increase 10mg every 6 weeks. some docs make increases every 2 weeks.

It will take several weeks for the full effect. You will have to be patient with this med. I’ve been on and off of it for the past year. I visited a new neuro yesterday and she told me that amitriptyline works better than nortriptyline in her experience, so she would like to switch those meds for me sometime in the future.

I agree with Mavlisa in that the key is to first reach a therapeutic dose and then give it a chance to work. Since you are still on a teeny dose (10 mg), it is less likely you will see much benefit. Can you contact your doc about possibly titrating up to next level?

Hi all . . . . thank you for your responses. I am so tired and want to go to bed but dread the thought because I know I will wake at 11:30 once again, wide eyed.

I think I am going to skip the d*** pill tonight and take it tomorrow morning instead and see how that works. I was going to do that last weekend but I had plans on Saturday and was afraid a new pill schedule would give me problems. Do you think this would be okay even though the directions say to take at night?

I so much want to get to a therapeutic dose to see if this is going to work. I’m only at 10 mgs, my doctor never even mentioned going higher and I don’t see him again until April. If I ever do get to the point where I am sleeping normally I’ll give him a call and ask about going up before then, but right now I think it is out of the question. God help me if I don’t get to that point.

I guess the consensus is that it will take a while before I know how this will work. I’ve thought about switching to amit, I know generally the side effects of that are more sedating than nort, but it would probably just have the opposite effect on me and I’d never sleep.

I am so crabby today. I don’t like myself at all when I am like this.

I had the exact same problem on ami. I got drowsy but it was as if the mechanism for entering sleep was turned off in my brain. I layed in bed all night like a zombie but couldn’t get any sleep at all.

I added a sleepaid (antihistamine) and that worked just perfect. Well I developed stomach-problems but I’m not sure anymore that was the ami’s entire fault.


For anyone using Nortriptalyine at the moment. How long did it take to work? I’ve been on a high dose of 70mg for about 8 weeks now. Started off with 10mg and been going up by 10mg every 3- 6 weeks.

Odd that. I looked at this older thread only yesterday. And some how I ended up checking out a few other similar ones. The standard comment in theory by medics is each and every preventative can take up to four months to really kick in. Most specialists will quantify that statement by adding ‘from reaching an effective dose’ which is the dose which controls most symptoms much of the time. However only yesterday I read of more than one person who experienced a positive reaction within a week. Also read @spinninggirl1 who has taken Nortriptyline several times each for 12 weeks and who said it takes five days to kick in. What’s more the ‘within a week’ posters and @Spinninggirl1 were all taking very low doses for example 10-25 mg daily. If you read @LucyLabrador’s diary she’s got to a higher dose than you and waited many months to achieve a modicum of success. In the Success Story section there’s a @DDAM1994 who from memory had reached 70mg with great success (suggest you read Daniels Success Story - just Search it doesn’t actually timeline but gives lots of Nori management hints) so I guess the answer to your question could well be ‘how long is a piece of string?’ I’m much afraid. Helen

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