Starting Nortriptyline ...questions

I have been on Verapamil 240 mg daily for over a month. My symptoms were daily pressure HAs, dizziness (sense of imbalance, dysequilibrium, sometimes a rocking sensation) and brain fog. The headaches have improved dramatically. The brain fog has also improved a lot. But the dizziness still comes and goes and on the bad days really isn’t much better since starting Verapamil. I saw a wonderful doctor in Delaware named Michael Teixido who has started me on Nortryptilene 10 mg. after a week I’m supposed to increase to 20 mg. Just wondering of those of you out there that have tried Nort…did your dizzinesss get worse initially? Maybe it’s the SE of starting a new drug, but today was a bad day after my first dose last night. If so, how long was it before the Nort started to help and dizziness improve?

Hi there,

Im on 12.5mg of Nort and have been for about 6 weeks. I started off with 10mg. I noticed a lil more wobbly sensation within 1hr of taking it, no big deal though. I now take it 15 min’s before bed and dont feel that at all. Even now if I take it and then dont get to bed right away, I dont have that wobbliness anymore anyhow. As far as being dizzy as a SE. No, it only made me feel better. I really really disagree with starting Nort at 10mg and increasing by 10mg every week. The dose for migraine on nort is 10-50, however some people may need more. It takes 2-6 weeks to start working. So if someone increases so quickly then they miss the opportunity to see if a lower dose would have helped and also, they titrate so fast that they do get side effects, which they may not have gotten if they went slower. For me I split the capsules and take 12.5mg. I do want to get up to 20 as I think that would be the best dose for me, but 15mg makes me a dizzy, so I need to stay at 12.5mg for a while longer. This has improved my dizziness 50-70%. On a couple days I had 90%. Im going to add 10mg of inderal la to it next week. (60 is the smallest dose in LA, but im getting it compounded)

Nortriptyline, from what I have read is one of the best drugs out there. On other boards and websites its rated 9 out of 10 for migraine prevention.
Im not there for that aspect on a small dose, but it is highly recommended for dizziness thru Dr Hain, (got this from a patient of his).

Good luck. Im tired right now and rambling and probaly missed alot of stuff, so please ask if you have anymore questions. I like this med. I tried Topamax and hated it. I tried Celexa, but cant really rate it as I quit after 4days from SE.

Many will tell you to keep taking it for at least 7-10 days as some had an increase with dizziness, that DID go away. If its still there or horrible, you can try splitting the dose by half. And try that for a few nights. If neither helps, time to call the doc.


Nori did not make my dizziness worse, but it didnt help me either.

I had a trial in december, and I went up 10, and then 20 after 1 week. It made me SO much worse. It was to aggrasiv to go up so fast. This time I started 5, then 7.5 after 2 weeks and then upped 2.5 every 2nd week. I am now on 20 mg. and I am defendly better. I do have sideeffekts, but nothing that can be compared to MAV… So I would recomend going slower…

Good luck, let us know!

I am also taking Nortriptyline and started on 10 mg and went up 10 every week until I got to 50, the only side effect I got was a dry mouth which is not really that bad any more. I’ve been in nori for around 11 weeks now and have only noticed a small difference but I’m am going to stick at it because any difference is better than nothing and hopefully I’ll continue to improve.

Thanks for the advice everyone. I am going to try and stick with the Nortriptyline for a few weeks. I don’t think I’ll increase the dose from 10 mg for at least 2 weeks. Hopefully I can tolerate it. I am very med sensitive. I have tried Lexapro, Effexor, and Cymbalta. I just don’t seem to be able to tolerate the SSRIs. I saw a new doc last week as a second opinion and he has much better luck with Nort than the SSRIs. In fact he says SSRIs only have a 15 percent response rate. I was encouraged that he did agree with the diagnosis. I feel like I’m finally on the right track.

Hi Jenn,

I started on 10 mg of nortriptyline in December. It initially helped me, especially with the dizziness. After about 6 weeks, I had a crash, and my doc moved me up to 15 mg. while I had some good days, the last few weeks I have seen increased dizziness in the afternoons and evenings. I have been on 15 mg for about 6-7 weeks. I moved up to 20 mg at night on Tuesday night. I am also sensitive to meds, so my doc has recommended a low and slow approach. My main side effects have been increased heart rate, heartburn, and dry mouth. They seem to dissipate after a few weeks, though. I will keep you posted on my increase. Hope the nori works for you! The good days I have had have been really good! I hope that this med turns out to be the right one for me. Good luck and keep us posted on your progress!