I had a very bad migraine brain and I disagree: 20mg of Amitriptyline killed most of my migraines flat - boom!
We’re not made of paper though. Of course things change with dose!
Scott founder of this site tried 5mg Ami multiple times and could not stand it.
I had to titrate from 20mg to 10mg of Amitriptyline over six month and anything more immediate ,messed up VM.
I am not contesting the efficacy but the sensitivity of the migraine brain to even 5mg increases of tricyclics.
OK fair enough, but I suspect it depends on the patient. Some people will be less sensitive, just as they respond to different meds in different ways. Hence the med lottery.
I’m just saying: don’t assume you are “med sensitive”, because this might just increase your anxiety about taking the meds: own goal!
Hello everyone,
Hope all are doing well.
I am in 20 mg for 3 weeks, and the side effect is less now. However, i still feel dizzy during the day. What is ur advice should i make the dose up to 30 or wait for another couple of weeks?
Btw, I am in Nortriptyline for 5 weeks now.
10 mg; 2 weeks
20 mg; 3 weeks
1 Like
Sounds like progress, good for you!!
Usually it’s month by month. I’d wait another week and then give 30mg a go. However, always consult your doctor first.
Thank you for ur advise 
My doctor is in different country, he is in uk and sometimes he take few days to reply.
1 Like
Pleasure Hope. I hope you get even more relief at the next level 
10 mg 2 weeks
20 mg 4 weeks
30 mg 1 week so far…
Total 7 weeks in Nortriprtyline,
And still feeling dizzy 
Unfortunately it often takes longer than this for the preventative drugs to work. You need to give it at least 2 months. Some people need to take a much higher dose than others. Some on
Nortriptyline have found relief at the low level you are on but others find they have to take 70mg or more. I know exactly how hard it can seem. It was many months before the drug I take, Propranolol, began to work on my dizziness and even then it did not stop abruptly just gradually over time. So it is a question of waiting it out I’m afraid. Do try to find distractions you can cope with and hobbies you can enjoy as you are at present. That will help to take your mind off of the dizziness a bit. I know it is hard not to be thinking about it all the time but doing so will actually make it worse. Anxiety alone can cause increased symptoms so do try to relax and accept that you are going to have to wait a few more weeks before you may start seeing improvements.
Thanks Helen, ur reply really means alot to me. I am trying to focus on something else, but the dizziness is in my mind even when i am sleeping, its really hard to be like this for 10 months… i have tried alot of medicines (antibiotics, antihistamines, Valium, valafaxine etc) and i hope Nori will be my drug…
1 Like
I’ve been on nortriptyline for I think 6 weeks? I’m honestly not sure. I’m at 50mg and working up to 100mg. I’m still crazy dizzy and can’t function much outside of my home but I did notice that this month with my cycle I had no face numbness/tingling and I’ve had zero pins and needles in my legs or arms for a couple weeks now. So I’m holding onto hope that nortriptyline is doing something for me and hopefully it’ll cut back on the dizziness soon. I’m here for you if you need any support, I feel like we’re both kind of in a similar position with trialing nortriptyline.
1 Like
Thanks Kara, i will be very happy if we keep in touch and update each other. 
Are u doing any migraine diet to eliminate the triggers ?
I haven’t yet. Still trying to figure out how to make it work for me while still being able to feed my family. I have noticed over the last year though that artificial sweeteners and certain food coloring are a huge migraine trigger for me. So I already avoid those.
Let’s cross our fingers that nortriptyline is the medication for us! 
I’m real sick of being dizzy all the time.
I am not sure of the diet benefits, since 10 months i am cutting the cheese, chocolate, tea, coffee, sugar (i add only brown sugar) gulten, Banana, spicy food, soft djrinks, i cut the bread also (today is my first day cuz I figured that bread is a big trigger for me)
Still feeling dizzy, head pressure & headache.
I hope Nori will be our magic drug!
Few doctors in the UK even suggest people do try a migraine diet. Mine never have nor my doctor. Cutting caffeine does seem to help many people and it is obvious to cut any obvious triggers. I haven’t eaten chocolate at all throughout my adult life or oranges. I’ve found reducing salt quite useful too.
@Onandon03 @Hope88. My neurologist never said anything about diet. He has asked about caffeine which i have cut back on significantly. He’s ok with small amounts of caffeine which I’m thankful for, coffee is my best friend 
I feel like I already have to restrict my diet with GERD so I’m struggling with restricting it even more, especially while trying to feed my kids balanced meals within my budget.
Eliminate it!
I have very bad daily headache since I increased the dose up to 30, i am not sure if this is normal.
Hi, I’m on venlafaxine and every titration up I experienced awful headaches worst run was almost 10 days solid… Nearly tipped me over edge… It then settled so if you can stick it out… If no decrease in headache ie duration or severity after 7 days, drop back for a week, then try again. I’ve had to do this many times… These meds are strong especially for us mav folks. Take care x
1 Like
If you search ‘increased symptoms on increasing dose’ you will find lots of posts over the years talking about this. There’s even one actually entitled ‘WHY do we always feel worse with every dosage increase’ so it is obviously very common most particularly with antidepressants. You won’t find - or at least at a scan read I couldn’t find - any answers however I have read off site that it’s just another example of migraine-type brain’s hypersensitivity ie all a result of Central Sensitisation which would seem a logical answer.