Lexapro, verapamil or nortriptyline first?

So after spending a lot of time reading through old posts on this forum and realizing I’m coming up on my eighth month and still off balance, I figure it’s time to try drugs! But the question is which one first? I’m already on a low dose 2.5 mg lexapro, although it tool me years to wean down ( was on 20 mg for some time for anxiety), so should I up that, or try the verapamil sr 120mg that neurologist suggested, and he says he has s lot of success with it and dizziness from migraine…or nortriptyline 10mg that I’ve had for a while too. Any suggestions would be welcomed, this board is very comforting and has helped me through some rough times recently. Have any of you that tried the verapamil had the sr form and if so did u cut it in half to start with or start right out with 120mg? I have such bad med anxiety so this is a big step for me. I also want to add in more exercise as I’ve also been scared to do that as well, so Im determined to start walking a mile a day and go from there, I know it’s not much but it’s something

I’d suggest the verapamil since it can also help with anxiety and you already have an antidepressant on board, although nort is a different class. I’m not sure on the starting dose since I’ve not tried that class of med before. Are you noticing any help with anxiety from the Lexapro? I wouldn’t make any changes with that just yet–keep it at the same dose and only change after you are stable at the dose you need to be at with verapamil if that is the drug you decide to go with. Those are my thoughts :slight_smile:

I think it’s best to make just one drug change at a time so your body can adjust to one at a time and you know what med might be causing any side effect or positive change.

Good luck!!

Quite honestly, you could end up taking all 3 of these meds…some docs would say no, but I"ve seen it happen.
Is lexapro helping your anxiety? I’m guessing it didn’t help your dizzies? Verapamil can lower blood pressure, so for me, it wasn’t an option. But it is usually well tolerated, so might be worth a shot? They say to take it in regards to your weight…so it you weigh 120 lbs, then 120mg would be your target dose. I would always start lower and go from there, but this med has a pretty tolerable side effect profile.
Nortriptyline is an antidepressant, but it hits mainly norephinephrine, and LExapro hits just serotonin, so they could be taken together. You would just have to find a modern minded psychopharmacologist (or just a good psychiatrist) to monitor your meds…
Good luck!

Hi Pharmgirl - I just started verapamil (my first med also). I am on Day 9 (120 mg SR) and have not had any side effects at all. I am not sure if its helping yet or not. I have had some stretches where I feel almost normal but then have also had some stretches where I don’t feel well… so really not sure what is going on. I have a follow up with the neuro today and have heard varying things on how long it can take before you know if its really helping…

I chose this as a starting med bc I am also very drug phobic and mostly phobic about “weird symptoms” so figured this was very unlikely to cause strange sensations etc. and so far nothing…

Still keeping my fingers crossed that it will work!!


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It wasn’t on your list, but if you are overweight and have normal blood pressure (that was my situation), Topamax is another to consider.

Thanks for the advice, I know I could potentially end up on all three meds which worries me bc they all make u gain weight! I used to have low blood pressure a the time, 90/60, but its weird since this all happened it’s always higher like 120/80 which isn’t high but I think verapamil will be ok, I think that is my first choice, what was the most noticeable side effect that anyone experienced with this one? I sti think I will cut it in half to begin with though to ease my mind. I’m currently experiencing allot of anxiety about tomorrow, I have to go out to a restaurant for dinner with 6 other people, I have avoided this since the start because of my disequilibrium makes sitting still very uncomfortable, any suggestions for that???

Do you have a benzo (ativan, klonopin, valium, etc.) to help with the anxiety? They can often help with the dizziness as well. I find them helpful while ramping up on a new med to help ease up the side effects. Or have you ever tried meclizine to see if that helps at all? It doesn’t always help me, but sometimes did take the edge off of a bad dizzy spell.

That might be helpful with your dinner outing to not only ease the anxiety, but take away some of the dizziness and disequilibrium.

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cant speak for Pharmgirl but getting benzodiazepenes (valium) out of GPs in this country is impossible. They will only prescribe 10 tablets per year if you are lucky. They are regarded as highly addictive.

I have some Xanax but d/t my med phobia I have never tried it, but I do take 12.5 mg meclizine once in a while when things get bad it just makes me sleepy. My number one symptom is my balance/rockiness. I just hate being still!

Verapamil and Nortriptyline are both very effective. Nortriptyline would probably be a good choice because of your anxiety.

where do you live where docs won’t give you benzos?