Andy,
Just refreshed myself with your background. Try the Venlaflaxine, it can help get some of your life back.
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Cheers 
I have a doctors appointment in about 2 weeks or so, so my plan is either the naltrexone, Pred, or venlafaxineā¦ might try Zoloft as itās apparently well tolerated?
Please let me know if you tried the naltrexone and what dose/for how many months. I was on 1.5mg for 5 days then 3mg for 5 days and have been on 4.5mg (Iām told thatās the highest dose where Iād notice benefits) for 30 days and my sleep doctor said that should be a good enough trial and my neurologist has never prescribed it before so he cannot advise. I know itās subjective and in general I feel like for migraine drugs, weāre supposed to stay on them for 3 months but it seems like a lot of doctors for certain drugs say if thereās no a substantial change after a month then that can signal something. Thanks!
naltrexone is somewhat unique because its thrown at a lot of conditions with vague indications. evidence for its use in pretty much anything is scant although its harmless enough to do āshot in the darkā things like this for ultra-refractory patients. anyway not surprised they would want to pull you off after a monthā¦given its MOA its unlikely anything else would happen
Makes sense though my sleep doctor said if I didnāt notice any substantial positive changes to stop it (he prescribed it for excessive daytime sleepiness) but if I recall, if I hope for it to potentially help with my chronic dizziness migraines, then Iād have to try it for 90 days total at that dose as I believe thatās the length of time recommended to see if a potential preventative can help with chronic migraines (the pharmacist agrees as why not, itās worth it to give it a try unless I hear anything different from my neurologist but itāll be $95/month for 2 more months so why not see if it can help me be not dizzy 24/7 which has gone on since 2011)
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right but its difficult to say naltrexone is a āpreventativeā ā if the primary indication was the sleepiness and it didnāt work thats the reason they pulled you off. there are far, far better preventatives that have more evidence that it would be better to spend your time trialing. not that trialing it is bad per se. its just that there more than likely are better options in the meantime
(unless its a shot in the dark, which happens and people do ā nothing wrong with that)
agreed but Iāve tried those so itās a short in the dark at this point:) (everything Iāve tried/am trying is here: july 15th 2025 Diagnostic/Trial History.docx - Google Docs
I did try it. I finished the whole bottle and felt nothing either way. You may be different but Iād look at fundamentals to improve your situation rather than specific medications to knock you into balance.
curious ā why did you only take venlafaxine for 2 weeks?
also i find it interesting that youāve never done a high dose steroid taper
pretty sure Iāve done prednisone and other steroids and I likely only did venlaxifine for 2 wks due to it making the dizziness intolerable
venlafaxine has a startup that makes the dizziness worse. i experienced that, although i took it as a sign the drug was working on the right system
I follow my neurologists advice and Iāve tried similar drugs in that drug class as well
Iād say 90% of the drugs Iāve tried have made the dizziness worse and Iāve spent 3-9 months on many of them with no change. Iām still trying to find something and I understand patience is a part of it
Hi, I have been on Celexa for 15 years now. I just saw this message.
Best,
Emma
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