Venlafaxine or Amitriptyline?

I was advised to take venlafaxine a few months ago, but after reading so many mixed reviews, I held off. More recently I was told Amitriptyline might be a safer bet, with less chance of side effects, and it helps with VM/PPPD/Occipital Neuralgia.

Can someone please help me decide whether to take venlafaxine or amitriptyline?

Please use search. I particularly recommend the Big Med Poll.

Also look at pages linked on the Wiki page: Drug Treatment

There are several problems with Topics like this:

  • you’ll only get a small survey of people who have recently been on the site so it ends up ragged and incomplete
  • it’s very personal.
  • there is loads of info already on each of the drug classes. Dig a bit

However, happy for anyone to chime in as you have been specific about choices. Perhaps someone has tried both of those drugs who is still visiting the site.

Please open another topic to discuss CBD Oil but preferably use search and take a look at POLL: What supplements have helped you?

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I always get annoyed when I hear this sort of question. IMO the diagnosing specialist or your own doctor should be suggesting the answer not leaving it to you, the patient. I don’t take either but from all I have read/heard Amitriptyline has less side effects and is far easier to get on/withdrawal from. Here in the UK the NHS recommend three drugs for MAV. They are Propranolol, Amitriptyline and Topiramate. Ami is an old long established drug and is used off lablel for many types of chronic pain. However Venlafaxine is highly rated by Dr Hain of Chicago. A newer drug So might be worth asking the medics where you are what they think would be best for you.

I appreciate your thoughts. I am also annoyed no Dr can give me a straight answer! They seem to think I am the expert that knows what and what not to take. I guess it is not an easy condition to provide medication for.

I’ve had both drugs. Start with Ami then if that doesn’t help you, try the venlafaxine.


There’s a wide choice of possible medication s available. It is impossible to prescribe one that is guaranteed to work for the individual in question. The migraine specialist neuro I saw said meds choice is just a case of trial and error. That’s probably one reason the UK’s NHS has published guide!ines.

I took amitriptyline for sixteen years with decent results after being first diagnosed with “vertiginous migraine” 20+ years ago. Then, out of the blue, my PCP switched me to topirimate because she thought it would be better. A few years later, the VM came roaring back and hasn’t stopped for two years. I took amitriptyline briefly after begging my PCP to try it, but the neurologist switched me to venlafaxine. It hasn’t helped, nor have the myriad other drugs. I’m currently back on amitriptyline, praying it might make a difference again. Everyone is different, so if you find something that works, stick with it.

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