Topamx success versus Nortriptyline

I have been taking Nort 20mg daily for about 6 weeks now and have not had any noticeable improvement in my symptoms. My doctor has recommended Topamax. Just curious to see if there is anyone out there that failed on Nort but had success with Topamax. I had a worseniing of my MAV symptoms when I initally started the Nort but stuck thru it for a few weeks. Things settled down, but now I am where I am before starting the Nort. I think that is why the ENT suggested giving Topa a try. Thoughts? BTW I have tried different SSRIs and couldn’t tolerate them at all. Maybe switching to an entirely different class of meds is the next step?

Hi Jenn,
I’m certainly not an expert but from what I understand 20mg’s of Nori is not very high. If you are tolerating the med okay then maybe you should try to go higher? I think most people get results when the get over 30mg’s, and I know a lot are on 50mg’s or higher. I’ve tried Topamax and for me it was a very intolerable drug. Obviously others have had great results on it.
Good luck!

I haven’t tried nort but have had great success with topiramate, the generic for Topamax. I also had success with three different SSRIs but not nearly as much as with topiramate. I am still on 2.5 mg Lexapro every other day, but plan to be off that soon.

I don’t know about nort, but as Elisha says, does it make sense to increase your dose since you’re already on that med? I don’t think there’s anything wrong with switching drug classes either though–as for me, my greatest symptom control didn’t come until I did just that.

And while some people find Topamax hard to tolerate, you will never know until you try. I found it very easy to tolerate myself, other than initial increase in dizziness which went away after a few days, and how well I feel now is worth it.

Good luck!


I am new to this board and I have not been diagnosed with MAV, but I am thinking that is part of my head CONSTANTLY feeling heavy and weird
and I have vertigo almost every morning when I wake up. I get up, have spinning, off balance. Could this be MAV?

Does anyone have MAV dizziness when they wake up in the morning?

20mg of Nortriptyline is insignificant unless you are experiencing bad side effects. I didn’t even feel it in my system until I got to 60mg, and my doc took me all the way up to 150mg. I’m back down to 100mg now. It is hard to know how much of an effect it had on me because I figured out my trigger at the same time that my dosage was increasing so, did I get better from the dosage increase or from avoidance?

I have started Topamax and I’m just bumping to 75mg today. I seem to be having some improvement on it already despite the fact that I’ve only been on it for about 12 days and only at 50mg so I am cautiously optimistic that it may help me quite a bit once I get up to 100mg.

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Does anyone have MAV dizziness when they wake up in the morning?

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Peashock, everyone is different, but in general, I tend to feel the BEST in the morning. Back when I was my absolute sickest I would wake up in the morning still dizzy. However I never woke up wose than I felt when I went to sleep. But that’s just my case–I guess I tend to sleep off my migraines.