Looking for the most gentle antidepressant for dizzy

I read too much about nori on this forum and most seem to get horrible headaches. Effexor seems to be one of the strongest and hardest to take. What about something like paxil, like Scott takes? does that help dizzy? I don’t have any headache since taking verapamil. But, I need something easy to take as I am soooo sensitive to meds. What about imipramine? anyone heard of it? Cymbalta? Anyone know what phenergen is?

I would actually say that Nori is the most gentle antidepressant. It has moderate-mild setotonergic reaction, and a strong impact on norepinephrine. The side effect profile is generally minimal at migraine doses, and it can improve both dizziness and headache in patients. Everyone responds differently to medications, and I think the people here who got worse headaches on Nori are the minority.

Effexor is a nightmare. I would not recommend it under any circumstances. There are tons of better options.

I just started 5mg Paxil with absolutely no side effects. Paxil hits serotonin very heavily, and has minimal or no impact on norepinephrine. Another good choice would be Cymbalta, it hits both serotonin and norepinephrine. So it really just depends on whether your brain needs that dual action, or whether serotonin is the mechanism of malfunction. In my case, I believe serotonin is the problem, so I chose Paxil.

Edit: Elisha caught a mistake in my post, so I corrected it.

I agree with Darren. For me Nort has been pretty easy to tolerate. If you go outside this website, and look at reviews, they are really good. :slight_smile:

K

Everyone is different. For me, Nori was a complete nightmare. Effexor was easier to manage. Then again, I’ve been extra sensitive to medications since MAV started. Still, I don’t think anyone can tell you that one med is really “gentler” than another – it depends on your body.

Darren means Cymbalta not Celexa :slight_smile: Cymbalta hits norep and serto. Celexa is just a SSRI. I’m tolerating Cymbalta fine, and did well on it the last time I trialed it as well. I think it’s a good drug but the norep. can hit pretty hard and make you a bit wired and anxious at first. I’m hoping Cymbalta does this trick for me this go round.

If it were me, I’d try Paxil. It’s recommended by Dr. Hain for migraine and it’s without a doubt a favorite of my GP for anxiety.

Nort was the easiest for me too. I took it at 9 at night and the only side effect I got was dry mouth, and that was sooo not a big deal. It also made me sleep like a baby too. I was not too tired to get up in the morning either. Very nice gentle med in my opinion…

Greg

Thanks, Darren for the information. I do tend to look to YOU as you seem to have studied this and are educated in the different drugs and what they do. Question: What are you taking? You said you tried Nori and thought it was gentle, then you said you just started Paxil with good result. Is that your cocktail. Nori and Paxil??? Or are you taking cymbalta? I wonder what a good cocktail would be for me. I am on Verapamil and am up to 210 ( yes, I am a lightweight) and I take some xanax when I have dizzy surges but very little and never more than .75 in a day. I am looking for that third drug to help with the very dizzy feeling have. I have no headache anymore while on Verapamil. ( It actually stopped working at 180 mg. and I had a headache again plus a hard spinning vertigo with vomitting and haven’t had that since I started verapamil) That is why I am trying to get up to the 240 mg. verap. I am very interested in you talking about paxil, as I have taken that WAY back a long time ago when I was working and busy with small kids etc. So I have heard of it and it sounds like it might be gentle on my poor migraine brain now. Does that sound like a good cocktail to you? Takes care of headache ( verap), takes care of spinning ( paxil) and takes care of surges ( xanax). ??? Thanks for helping and if you find time I do value your opinion, Darren. I see Dr. Hain on Fri. in Chicago. Meredith ( spinning lady)

elishat, Thanks for advice regarding Paxil. I see you would try it and Darren says he likes it and is trying it, so I am thinking I will ask Dr. Hain for it. Can you do that? Ask for a drug? I will tell him I cannot go the effexor route and Nori …well, I don’t know what to say about that. So many have said they have violent headaches from it, but then some just love it, so who’s to know. BUT, I am clinging to hope that Paxil might work. What I need is something for being dizzy. I don’t have a headache. Do you think paxil will help the dizzys? Wonder how you know if your problem is serotonin or norepinephrine or both? How in the world do you know that? Darren says his is serotonin. hmmmm. Well, I am going to go with your advice and try to get Paxil. Leaving in the morning, driving the 7 hours to Chicago, spending the night there and see dr. Hain at 10:30 Fri am. Thank you for helping. and Hugs to your little baby!! Meredith ( spinning Lady)

Hey Meredith,
Darren has done TONS of research and has found so much information that shows a very strong correlation regarding the lack of serotonin and how it effects the vestibular system. I have also read in the info he has sent to me that serotonin deficiency also causes migraine. That’s why he said his problem is serotonin. You could ask him to send you some of his research. I will also tell you that Dr. Hain states on his webpage regarding Paxil, that he favors it regarding migraine. The reason I’m taking Cymbalta is bc I have taken it before, it helped and I tolerate it well. I’m not taking it bc I think my problem is norepinephrine and serotonin. However, there is also research (and Hain has this on his website as well) the norepinephrine is involved in the vestibular system. I just don’t think it’s as important as serotonin.
So are you going to see Dr. Hain? And yes, you absolutely can ask for a medication.
Thank you for the hugs for Lucas! Good luck!

Elisha,
Can you tell me where DR. Hain says Paxil is good for migraine? It seems to me he only recommends the tri’s or Effexor…I would like to read that.
THank you!
Kelley

— Begin quote from “spinning lady”

Thanks, Darren for the information. I do tend to look to YOU as you seem to have studied this and are educated in the different drugs and what they do. Question: What are you taking? You said you tried Nori and thought it was gentle, then you said you just started Paxil with good result. Is that your cocktail. Nori and Paxil??? Or are you taking cymbalta? I wonder what a good cocktail would be for me. I am on Verapamil and am up to 210 ( yes, I am a lightweight) and I take some xanax when I have dizzy surges but very little and never more than .75 in a day. I am looking for that third drug to help with the very dizzy feeling have. I have no headache anymore while on Verapamil. ( It actually stopped working at 180 mg. and I had a headache again plus a hard spinning vertigo with vomitting and haven’t had that since I started verapamil) That is why I am trying to get up to the 240 mg. verap. I am very interested in you talking about paxil, as I have taken that WAY back a long time ago when I was working and busy with small kids etc. So I have heard of it and it sounds like it might be gentle on my poor migraine brain now. Does that sound like a good cocktail to you? Takes care of headache ( verap), takes care of spinning ( paxil) and takes care of surges ( xanax). ??? Thanks for helping and if you find time I do value your opinion, Darren. I see Dr. Hain on Fri. in Chicago. Meredith ( spinning lady)

— End quote

Thanks for the kind regards! I try to learn as much as I can about the antidepressants, but Im still learning! Im glad Elisha caught my mistake earlier.

I tried Nori for almost 6 weeks, and got my dose up to 30mg. The only side effect I experienced was dry mouth from the anti-cholinergic action of Nori. I felt a tiny bit better while on 10mg, but that did not last long. Nori does not hit serotonin very hard unless you get to a high dose. And I didnt believe I needed to be hitting norepinephrine at all, and Nori is a hard hitter on that.

Im glad the verapamil stopped the migraine headache and acute migranous vertigo. My personal belief is that an antidepressant is a good choice for the remaining chronic dizziness. If you have a history of anxiety (which is extremely likely since you are a migraineur), then an antidepressant will probably treat the chronic dizziness. Its possible that an antidepressant can singly treat all of your symptoms without the need for verapamil. But I think it would be best to keep verapamil and supplement with an antidepressant. A benzodiazapene like Xanax is great for times when you have increased symptoms. I would encourage you to find an experienced doctor who is familiar with using 2 or more medications.

I have been on 5mg Paxil for 3 days now with no side effects. Its too early for the med to start working, but Im pleased with my experience with it so far. I shall be titrating to 10mg in a few days, lets hope the side effects stay down.

Hi Kelley,
Here’s the link to Hain’s page regarding the Paxil. I should have clarified that of the SSRI’s he favors Paxil and I think Prozac regarding migraine. He’s definatley all for tri’s and Fex for MAV.

http://www.dizziness-and-balance.com/disorders/central/migraine/migraine%20prevention.html

Hi Meredith -

Of course you can and should express any preferences you have whenever you go to see a doc. But I don’t think the ideal approach is to walk in and announce you want a certain drug.

It’s a good idea to give the doctor a list of all the meds you’ve tried already without success (and indicate whether you got no relief or if you had side effects, and what those were). That’s the right way to politely inform the doc about some of the meds NOT to prescribe right off the bat.

As for a preference, it’s also perfectly fine to let him know you’re in touch with other MAV’ers through this online support group, and that through “talking” with your online community, you’re leaning toward Paxil because you’ve heard good things about it. Then ask what does he think about it for your situation? Your symptoms and other medical issues profile are the things HE gets paid the big bucks to take into consideration before a prescription is written.

For example, I have periodic limb movements in sleep (I kick or twitch but I’m unaware of it; my husband first told me about it). My neurologist never even offered me an antidepressant. I didn’t know it when I first went to see him, but I’ve learned since then that antidpressants can make periodic limb movements in sleep worse. Since I had told him about this condition when going over all my other medical history with him, HE knew that eliminated a whole class of meds when deciding what to give me for MAV.

And do bring a notepad with you - you will be nervous and it’s hard to remember everything that transpires, so take notes!

Elisha,
Yes, I am very familiar with Dr. Hain’s site…it helped me tremedously when feverishly going over all this stuff in the beginning (3 years ago). I look over it now and again to see if he has updated it.
I see where it mentions PRozac as ineffective in his experience, but perhaps worth a try. The Paxil is noted for chronic daily headache…I don’t see him being a fan of any of the SSRIi’s. HOwever, other docs will go straight
to them, like Celexa from the Mav guy at UCLA (sorry I can’t remember his name…it’s early still :slight_smile:
I frequently wonder why the push for the Tri’s and wonder if it’s because it was the go to med at the time, but if other drugs, like Cymbalta, hit the same receptors, why wouldn’t they be a good choice? I take Cymbalta and it’s helped me very much. I know of 2 others on this site that also got help from it…yet Dr. Hain says it’s minimally effective and raves for Effexor…
So confusing.
Kelley

So are we born only with a “limited” supply of serotonin? Like when we worry, are we using it up and doing damage?