If you can work through the side effects it may well prove to be so. Reaching an effective dose is important. Quite a few on here have had excellent long-term success controlling MAV at 75-85mg sort of level. I’ve noticed that recently whilst searching for something else.
@turnitaround I’m working on it! I used to have 3-4 cups of coffee every morning and now I have 3-4 a week.
@Hope88 @Onandon03 one thing I’ve noticed is the higher the dosage the less side effects I feel whenever I up my dose. If that makes sense? I’m not suuuuper med sensitive but more so than the average person.
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Great! Now change those to decaf. 
verses up to 200mg!!!
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I’m almost done with my current bag, I’ll pick up decaf next time! 
I’m working on eliminating MSG also. I already don’t drink and don’t consume anything citrus due to acid reflux. I don’t eat much dairy or chocolate so those two should be easy for me to cut.
Caffeine is my biggest weakness…
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Caffeine is an addiction. It modifies your brain physiology. It takes will power to quit it. But reduce it I did and I was so much more comfortable.
MSG should be easier to avoid? I found MSG a bad exacerbator.
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Good news, i think your body get used to the drug. I hope that minimum dose will work for me i am not happy with higher doses of medicine (i did not try higher than 30)
Kara, How long u have been in Nori ?
Going way off Topic here but have to disagree there. MSG is pretty much everywhere, everywhere ‘savoury’ that is, and it lurks under so many different disguises. Apparently it isn’t possible to totally eliminate MSG as it does occur naturally in some foods. I think it’s possible to substantially reduce intake of MSG. That was as near as I could get. A good starting point is to cut out all products which actually contain ‘added’ MSG. You cannot reduce it gradually like caffeine I agree but to reduce it you need to find it first and that is the difficulty. Caffeine is easier to avoid. Both are common triggers. I’m sure cutting MSG where possible helped me and doing so also led me to realise salt is probably another trigger for me. MSG and salt do seem to hang out together in many products. So that’s something else I’m always keeping an eye on.
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Good point Helen, thank you!
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A post was split to a new topic: Has anyone combined nortriptyline with an SNRI/SSRI?
I started nortriptyline mid December. I’m at 50mg now and will probably up to 60 this weekend.
Kara, are u going up every two weeks ?
Hello everyone,
I am really confused, my doctor asked me to go up every two or 4 weeks. yesterday i have spoke with him (video call appointment) to update him about my progress. I informed him that currently i am n dose 30, still feeling dizzy, more headache (I am not sure if this is Nori side effect but i have more headache than before) also i mentioned that by end of this week i will complete 4 weeks on dose 30. Should i go up to 40 ?
I surprised with his answer, i thought he will say yes go up. But he asked me to stay in dose 30 for another 6 weeks !
I explained, that i am afraid to waste my time in dose 30 without any benefit. But he did not comment on my concern.
If dose 30 did not help me during the past 4 weeks, is it gonna work after 6 weeks ?!
Very confused…
I’m upping my dose every week or two. Kind of when I feel ready for it. My neurologist wants me to work up to 100mg and be there for a few weeks to see if this is the drug that works for me.
What was his reasoning at staying at 30? It seems like such a small dose especially if you aren’t experiencing any relief yet.
He did not give me a clear answer. Even when i told him i am afraid to waste my time, he said we will wait and see
The problem is I lost my confidence on doctors.
Please dont blame me, I saw more than 20 doctors or maybe more in my country with no benefits. they keep saying your crystals is moved and we cant get them back, and i did the maneuvers many times, took lot of medicines (Not antidepressant) & i did many VRT sessions for long time.
Even when i went to uk for treatment I spent two months without clear diagnose.
I remember my last visit to ENT professor in uk, i saw him 3 times and every time he do for me maneuvers (i informed him i did this in my country! So why should we repeat it he said they did it wrong). When i visit him last time he told me for sure u feel better i answer no i am still dizzy and very dizzy. He saw me on my face and said i cant do anything more. I felt that i want to cry (actually i cried alot that night)
He is professor, at least he should advise me to see a neurologist.
After my research and reading and visiting this website i decided to see neurologist and i told him i may have MAV (opposite way ,) but to be honest he recommend Nori, I told him i want to try Ami because of others experience.
I started Nori at 10 and after two weeks i went Up to 20, i felt horrible and more dizzy. I asked the doctor should i stay on 20 or go back to 10 he advised me to go back. hmmm, But i did not listen to him (if you ask me why? My answer is because i dont trust any doctor) i know this is wrong but i dont know how to change this idea.
I stayed on 20 and felt improvement after 10 days of side effect.
Then i go up to 30, i feel that the progress is slowly and no big difference between 20 & 30.
Now, he want me to stay on 30 for 6 weeks more…
Hope I share much of your past experience with misdiagnosis. I was misdiagnosed with BPPV (crystals) just like you for 12 whole years but that’s history now. We are where we are. You have consulted a neurologist now. In the medical pecking order they are very near the top of the tree. Other medics listen to them. Friend of mine waiting for major surgery was referred to a neurologist by her kidney specialist surgeon just a few weeks ago and the kidney surgeon consultant is following the neurologist’s recommendation. So just maybe your neurologist does know what he is talking about. He’s certainly had many years training to get where he is. He will have his reasons for offering you Nortriptyline rather than Amitriptyline. Nortriptyline has fewer side effects and is gentler to take. All preventatives can take up to 4 months to work fully. Your neurologist wants your condition under control at the lowest possible dose. You aren’t ‘wasting time’ on a lower dose you are trying to see if that dose will be sufficient for maintenance. No drug is without side effects and bearing in mind you may be taking this drug long term you don’t want to be taking more than necessary. The longer period on the lower dose will also give your medication sensitive system longer to get used to it. Two reasons to wait it out. Nortriptyline has an excellent long established record for success with MAV symptoms. So I’d try to be patient and go along with the advice you have received.
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If you aren’t too happy with the care you are receiving from your current doctor, can you request to see a different neurologist? It took me months to get in to my neurologist and I had a referral from my primary. I live in the states and I’m honestly not sure how it works elsewhere, but if I wasn’t happy with my neurologist I could just request to see someone different.
I understand your frustration because we all just want some form of relief from this dizziness. It’s horrible to have to live this way.
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Hi hope, its super hard having to manage mav day to day especially when trying to make decisions medically in terms of your meds, your dose, timing, interpretation of side effects vs symptoms etc… To be honest it’s exhausting and can be overwhelming.
I’ve experienced this many times too. I’m going to take a guess at the 6 weeks on 30mg… Its possible he took a conservative approach because you are still feeling poorly and seeing an increase in headaches. The fact that it helped at the 20mg shows potential but perhaps going up will just take time. I can certainly speak from experience on that, every 5 or 10mg increase threw me in a tiz and I had massive increases in headaches in duration and severity. My neuro on hearing this advised to slow down and at one point said stay at dose for 2 months. I’ve learnt it’s good to listen to the neuro but more importantly listen to what your body tells you. Maybe consider settling your anxieties by accepting the 6 weeks but also agree with yourself that if in 4 weeks, headaches have reduced etc… Then go up another bit. It took me about 15 months to get to the right dose and a whole lotta patience. From all I’ve read on here nortrip seems to be kindest of them and I think our bodies need a friend, even today if it doesn’t feel like it. Remember neurons and medics will all give their own spin, you are the decision maker and therefore take comfort in that and trustyourself to find the next step forward. Stay hopeful and know that you will get good days for sure, just keep on stepping thru them. Best of luck and keep us posted x
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any updates? I also had the same experience and couldn’t continue due to how badly the side effects were making me dizzier.