Migraine and nortriptyline

Hi All
just joined this morning and found everthing very helpful , but noticed no-one mentioned nortriptyline, I have been prescribed by doctor to take one 10mg at night for 1 month to prevent migraine which I have on a daily basis.

I am a bit reluctant to take these as they are an anti depressant , can anyone advise me as to their effect if any , I also have vertigo and extreme tightness in my head.

thankyou all

Ross :roll:

Hi ross

Welcome to the forum.

Nortriptyline is very much like amitriptyline which you have probably seen mentioned on the forum in some threads. Both are tricyclic anti-depressants, but have far more uses than for just depression. In fact they are rarely used for depression anymore, as the newer class of drugs (SSRIs) are better tolerated in the doses required for depression. Fortunately, only a low dose of tricyclics is usually required for migraine and other ailments like chronic pain.

Some people have dramatic success with these drugs on low doses like 10mg, while some get no benefit even at 100mg. The name of the game is really to accept the need to be a lab rat, and try drugs until you find something that works for you. My impression (which is just from others recounting their experiences) is that the tricyclics are moderately effective. If they work, they tend to work really well however. I get the impression lately that Topamax is proving to be extremely effective for this condition. It is not the first to try though as it has some bothersome side effects.


Hi Adam

Thankyou for all your information on nortriptyline

Kind Regards

Ross :slight_smile:

Hi, this question raised by Ross and answered by Adam is really helpful to me too.

I am having a really bad time right now - the vertigo is not worse, it is minimal, still there occasionally but I am getting the most horrendous migraines which have managed to keep me housebound this week for 4 out of 6 days. The pain in my head is so bad that I am not keen to walk out on my own as I will be prone to vertigo right now. I paid a return visit to the Migraine Clinic in London and they have suggested that I try a daily med - either a beta- blocker or amitriptyline - like Ross I am really concerned about taking medication every day - but I realise that I am in such a state at the moment with this bad phase that I can’t go on as I have been. I’ve opted for the beta blocker (to start next week) as I feel it may be less problematic to take in the longer term - has anyone got any views or experiences on them and how did you find them if you tried them out? On top of that I am going to physio for my back and neck and I think this has helped a lot till this current phase - I had two whole weeks without migraine before this current setback 10 days ago. Now I feel I’ve gone back 10 steps after gaining 2.

Adam - I think you are right about being willing to be a guinea pig - but I can’t help but naturally resist the daily drugs - but it looks like I have no choice as I will not be fit for work or anything otherwise if this current cycle doesn’t stop soon. I am feeling so upset about it all right now, I am in the middle of a war of wills with my body - I feel pretty useless and quite isolated. I’ll cheer up as soon as I get through this glitch I guess.

Mrs G.,

I can’t say anything about beta blockers spifically, because I have never taken them. I can say though that I was on a steady state of dizzyness for almost two years before I got a doctor to diagnose me with MAV. I was at the point that walking and standing were becoming a dangerous challenge for me because I would fall way to often. I went through three different meds before I found one that has given me relief. I am now taking Depekote, (sorry, I don’t know what family it is in) and I have gotten over 90% of my life back. From my experience I recomend the search for a medication that works for you.

Hi Mrs G,
I know exactly what you mean about not wanting to take daily meds. It really goes against the grain for me too. But like Brian said to find a med that works is such a relief and to claim your life back to some extent has got to be good.
I started on beta-blockers Metoprolol Tartrate around two months ago on a very small dose (50mg per day). This was because I am very sensitive to side effects (Pizotifen wrote off 12weeks of my life last year!). So far so good. After a month I increased the dose to 100mg a day. I have also started taking vitamin B compound at the same time. Although the dizzy spells have not decreased in number, the verocity of them and my recovery time have seriously improved. I am wiped out for the rest of the day, not the 5 to 7 days as was the case. For me this is a major step forward. I have also been taking Rizatriptan meltlets which are fab for knocking the vertigo on the head but do nothing for the rest of the migraine. So at present I’m the best I’ve been for the last six years! :smiley:

Getting back to the original topic of this post, I just found out that I have been taking nortriptyline for jaw clenching. I like to grind my teeth at night and clench them during the day to the point that I am causing my teeth to be extremely temperature sensitive. One of the effects of this medication is as a nuero-skeletal-relaxant which is why I am taking it. If I understood my doctor correctly, it is supposed to help relaxe the muscles where they connect to the bones in your body. Maybe you were prescribed this med to help with the tightness in your head that you mentioned.

The only problem that I have with this med is that it has decreased the effect of the main med that I take as a migraine preventative. As a result, my dizzyspells have gained in strength to the point I can’t work through them anymore like I used to do. I’m not getting the 24/7 dizzyness that I lived with for a couple of years, so things are still on the upside.

Thanks Brian B and Lizzieb for your replies - it is really helpful to read your experiences, I often need a pep talk from a fellow sufferer to keep me objective about the practicalities of illness management.

I have had 5 days without a migraine now - hooray! However I have not started the beta blockers yet - I have gone back on feverfew capsules which appear to have settled me down (sleeping at night, no headaches) - so far, so good. But at the next relapse I will be trying out the beta blockers for a few weeks to see how they go. My resistance to them is purely to do with them being a ‘daily drug’ rather than one that is taken ‘on demand’. But it is clearly a necessary evil if the alternative is worse.

I wish you all healthy days.

I was DX’d with MAV in July 07 after a year of dizzyness and vertigo, along with other symptoms.
Before being diagnosed with MAV, I had been given Ativan to help with anxiety when you know an attack is coming. It turned out to help quite a bit, so Dr. prescribed Clonazepam to try at 10 mg twice a day as it’s affects last longer. For me, within 3 weeks, all symptoms had started to ease off leaving me at almost 90% most of the time and then having setbacks.
Since the addition of Nortryptyline after being diagnosed with MAV and working up to 25 mg at night in addition to clonazepam for almost 2 months, I am close to 100% all the time and hoping it will last.
So far so good.