Nortriptyline questions , reassurance needed!

Hi everyone

I’m new here : ) . Ive had a VM diagnosis for 8 months now , DX by Dr S.

My symptoms are basically bobbing on a boat and feeling floaty 24/7 . Usually ok when sat still and lying still . I have been on nortriptyline for 8 weeks now and I’ve been on 30 mg for 3 weeks . Dr S wants me to work my way up to 75-80 mg and stop at a dose that alleviates my symptoms .

My question is … how long can a med take at a specific dose to see if it works … 8 weeks ? Has anyone been on this and only seen results at higher doses . I want to go all the way up but want to know that even if you don’t see results at lower doses , it may still eventually work .

What dose worked for people and did they have to get to that dose before they saw any improvement ? At 10 mg for about a week I nearly felt 100% and got over confident and had trigger foods even alcohol : / , then symptoms came creeping back . Now on 30 and haven’t seen anything like that since . I have better days than others but it’s always there .

Many thanks ! Ria

Hi, and welcome to this forum.

Unfortunately there’s nothing very specific about treating MAV. Which drug works for you is very much a matter of trial and error, as is the effective dose. Each individual varies, in symptoms, severity of symptoms and amount needed to control symptoms. I very much doubt anybody can give you a definite answer. The drug you take is one commonly used to treat MAV and it does work well. Providing you aren’t having serious side effects you need to stick with the drug some time. Theory is it can take 6-8 weeks to even start working and if you had no improvement after 4 months the medics would look at alternatives. You saw Dr S who is eminent in his field. Didn’t he give you any indication of how often and under what circumstances to increase the dose. Perhaps a call to his secretary may be necessary and he/she could rely info on your behalf or you could try speaking to your own GP who may well be able to help. I have been referred to general written info on amitriptyline (which is another drug of the same class) by the neuro-otologist I saw and in that it is suggested to increase by 10mg every fifth day.

It’s good you don’t appear to have side effects and that 10mg did appear to help. Stress won’t help MAV one bit. It could be you are a bit stressed worrying about whether it’s working which is totally understandable but maybe why you don’t appear to have noticed any further improvement yet on the slightly increased dose. I don’t take noratriptyline myself but many on this forum do and will get back to you shortly I’m sure. Many have found they do experience side effects each time they increase the dose. Just because you aren’t seeing results yet on what is, if you think about it, less than 50% of Dr S’s suggested dose doesn’t mean you never will. Treating MAV tends to be a bit of a long and slow process I’m afraid which rather goes against the grain in this Instant Age we now live in.

Under the Welcome Section you’ll find lots of info on MAV including from Dr S and other eminent experts. Do take a look.