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Nortriptyline questions

Just started 10mg of nort after getting no response from Effexor for 3 months.

I have a new ENT Who specializes in migraines but I do not see him for another month so I’m just looking for some insight.

For those who are on it, what dose did you find any relief from? How long did it take approximately?

I also received a shot of Ajovy which gave me so much relief from chronic daily headaches so far.

Hi. Suggest you try the Search facility as there’s a lot of info on here although currently the only regular active poster I can recall taking Nort. currently is @LucyLabrador who I’m sure will correspond to yiu in due course. Only other I can currently recall is @naejohn who I think’s at 70mg now but she titrated up on Amitriptyline initially and so only recently swapped over because of weight gain. If you check through ‘Success Stories’ there’s Daniel (who’s now training to be a neurologist) and he was successful at 70mg. However everyone is different and I’m almost sure he probably rested a long while somewhere lower and the 70mg is much the result of a later increase. There’s not much exact science about either dose or timescales. Experts say preventatives can take up to four months for optimum effect but most see some improvements long before that. No such thing as a quick fix I’m afraid.

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Thank you so much for the info! I know there’s no simple solution, I’m on my fourth med with no positive results for the past 9 months so just hoping for some sort of relief soon!

Very sorry to hear that. Which failed you previously? It’s a cruel and often relentless struggle coping with MAV.

Thank you- yes it is! I originally was told I had PPPD so started on Zoloft then Cymbalta then venlafaxine. I also trialed Topamax but had weird episodes of confusion so stopped. I suspected vestibular migraine from the start but finally found the right support so I’m hoping for more positive results now but the waiting game is difficult as we all know!

A thread ‘Been on Nortriptyline for over ten years’ may interest you. 85mg that poster was taking with great success it seems. You should find it kinder than Topiramate for sure.

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I’ve been on nortriptyline for coming up to a year now. I titrated up slowly with a good month between each 10 mg increase. I’m currently at 90mg. This was the max my neuro set for me.
Nortriptyline has been mostly ok for me in terms of side effects. It took ages to get some positive change though. I think I started to feel something only from 70 mg. but you might react differently and much earlier, each person is different. Try to stick with it if you can until you’ve reached the max dose your consultant sets.
I’ve now added in a second medication because just nortriptyline wasn’t enough.


I have been on and off Nortriptyline for 8 years now and it has worked wonders. Started at 10mg, went up to 25mg rather soon after. Stayed on 25mg for a few years and was symptom free so I went back down to 10mg and then off of it for a year or two. Then I experienced a lot of stress and symptoms began ramping up again. Went back on it and have stayed at 25mg ever since. I’m having a bit of an episode recently due to environmental factors, but aside from that I’d say I’m 95% most of the time if I avoid my triggers.


So great to hear thanks for sharing! Did it take awhile after being on 25mg to feel better or did you notice improvement quickly? So great you found what works for you!

It was about 8 years ago that I was put on Nortriptyline so it is hard to remember. I got a lot of symptom relief when I figured out my triggers. A big one for me as aerosol sprays, and I was working in a hair salon at the time. Once I quit and got myself out of that environment, and did an elimination diet to figure out my food triggers I was a lot better off. Adding the Nortiptyline helped me get an even higher threshold so if I was exposed to one of my triggers it would take more of it to actually set me off. I would give it a month to start working and keep titrating up slowly to give it a fair trial.

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