I am very fatigued due to MAV, but nortriptyline (I am taking 10mg at approx 8:30pm) makes me even more groggy. It knocks me out at night, as if I took a sleeping pill, and the grogginess is present well into the next day on top of the fatigue that I already experience from MAV. I am 10 days on med. I question whether I’ll be able to tolerate this med, as I have to go much higher, but i really want to stick it out as I know it’s helpful for many. not sure about the leg fatigue, Seth, as I’m way too dizzy to walk very much.

Hi everyone,

I had a question about nortriptyline. I’ve been taking this drug for almost 3 months now and I’ve noticed a fairly significant improvement (I’ve described it as 85-90% normal). With the success, I’ve been wondering if this is a drug that eventually wears off? When I had MAV at my worst I felt about 50%, so I’ve had a 35-40% increase. Is 85-90% my new baseline if I go off the drug? My doctor has been telling me that you go off of a successful drug after a year. I know I’m thinking way ahead here, but was I was curious to see what you guys thought. I’m taking 50 mg right now and the side effects aren’t bad either (slight fatigue). I’m actually thinking of taking 60 mg at some point to see if there is another level improvement, but I’m going to wait on that to see if my body fully adjusts to the fatigue. I realize you guys aren’t medical professionals, but you are experts on MAV. Any insight on this would be greatly appreciated!


Hi Seth,

Is 85-90% my new baseline if I go off the drug? My doctor has been telling me that you go off of a successful drug after a year.

It is most probably the drug that is giving you this new baseline. If you stopped it right now you’d probably slide back to where you were. It may be that after a year it could stick without the drug but there’s no guarantee. Some may need to stay on a med to control this for a very long time. Keeping your lifestyle in check and avoiding triggers is just as important too as a med is not a substitute for that. From Rauch, “For those patients who do not achieve adequate symptom relief by diet and lifestyle, migraine suppressants can be used as a SUPPLEMENT to (not a SUBSTITUTE for) the diet and lifestyle.”

Cheers … Scott

Thanks for your reply Scott! I think my case is slightly different from a lot of other MAV cases. My only symptom is dizziness all the time, with no episodes of vertigo. My doctor never suggested a diet change either; I’m assuming he didn’t think my diet caused the sudden MAV onset. All he has told me to do is take the medication, and as I said there has been a nice improvement. So I guess there is a possibility I may have to be on this medication for the long term(assuming it doesn’t wear off) to maintain at least feeling better. Hopefully the MAV will wear off before the medication, that would be nice. :slight_smile: