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Doctor insights on: Nortriptyline Migraine Dosage

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My doc wants to put me on low dose aventyl (nortriptyline) for migraine 'aura' and anxiety, but I hear it has some nasty side effects. Any medication that is safer?

My doc wants to put me on low dose aventyl (nortriptyline) for migraine 'aura' and anxiety, but I hear it has some nasty side effects. Any medication that is safer?

Similar medicines: Medicines similar to aventyl are amitriptyline and nortriptyline. They have been around longer, and they are often used to prevent migraines, but they may not be as effective for mood. If you do not have a migraine aura often (2x/wk) you do not need a preventer. There are many other options for anxiety if you do not fancy this medicine.

Dr. Ravi Chand
244 Doctors shared insights

Nortriptyline (Definition)

Classified as a tricyclic antidepressant, and considered of modest benefit these days due to significant anti-cholinergic side effects (drowsiness, dizziness, dryness of mouth, blurring, and perhaps effect on bladder). Confusion may occur in older folks. Had some value in migraine prevention at one point. Used rarely these days as ...Read more


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I was wondering if anyone is prescribing pamelor (nortriptyline) for migraine headaches?

I was wondering if anyone is prescribing pamelor (nortriptyline) for migraine headaches?

YES: Pamelor is a tricyclic medication it is nortriptyline and a metabolite or breakdown product of the parent compound Amitriptyline (elavil). It may have fewer side effects as the metabolite. Start low and go up slowly per your physician's recommendations.

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I have had vertigo for 14 weeks now. Very bad at times. Mri and other testing all normal. Migraine associated vertigo is the diagnosis. I'm on nortriptyline, just started. How long does the vertigo typically last. Its been so up and down?

I have had vertigo for 14 weeks now. Very bad at times. Mri and other testing all normal. Migraine associated vertigo is the diagnosis. I'm on nortriptyline, just started. How long does the vertigo typically last. Its been so up and down?

There is a condition: Called Benign Paroxysmal Vertigo and seems to come out of nowhere. It sometimes goes away without treatment but since your vertigo has lasted for 14 weeks, you need to see a neurologist to explore other conditions causing the vertigo. Your PCP can refer you to one.

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I'm a migraine sufferer and have found great relief from nortriptyline. I recently heard a loud swooshing in my ear for a couple of days. Problem?

I'm a migraine sufferer and have found great relief from nortriptyline. I recently heard a loud swooshing in my ear for a couple of days. Problem?

No: The carotid artery normally passes though the bone that houses the auditory nerve. When air conduction is temporarily impaired, one hears the internal sound which is soft and usually not audible. A "clogged ear" like after swimming, from a wax impaction, following a cold, or changing altitude can cause this. It's not serious. Lying ear firmly down in bed can temporarily reproduce it.

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Added 10 mg nortriptyline (nummular headache) to 50 mg trazodone (insomnia) with 60 mg cymbalta (duloxetine) (migraine). Felt dizzy, drugged & weak so stopped trazodone. Feel better, but can't sleep. What to do?

Added 10 mg nortriptyline (nummular headache) to 50 mg trazodone (insomnia) with 60 mg cymbalta (duloxetine) (migraine). Felt dizzy, drugged & weak so stopped trazodone. Feel better, but can't sleep. What to do?

Insomnia: A poor sleep technic perhaps. Insomnia can occur when the environment where you sleep does not facilitate this important process. Make sure you have no distractions in the room like a tv, laptop. Ipad, smart phones, books, etc.. If still having problems may consider evaluation for restless leg syndrome or depression. Exercise during the day, not at night. Tell your physician about side effects.

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Just upped my dose of nortriptyline from 5mg to 10mg and experiencing some increased anxiety from it. Racing heart, jittery, nervousness. Is this normal? I had no side effects intially and it has helped my migraines. Wondering if it will go away.

Just upped my dose of nortriptyline from 5mg to 10mg and experiencing some increased anxiety from it. Racing heart, jittery, nervousness. Is this normal? I had no side effects intially and it has helped my migraines. Wondering if it will go away.

Maybe: In general, anytime you increase the dose of medicine it is possible to have side effects. Usually if a side effect will go away it will do so after a week or so. You can also try to increase the dose a little more slowly. Best wishes.

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How much nortriptylene should I take for migraine prevention?

How much nortriptylene should I take for migraine prevention?

Smallest dose: Amitryptyline is a good preventative medication for migraine, if the diagnosis is correct. Sometimes even 10mg per day is sufficient as it does not work in the capacity of an antidepressant when given for migraine in my opinion it is better than nortryptyline for this purpose.

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I am taking nortriptaline 30mg for migraine 2 days now. Having rapid heart beat after taking. Shall I continue taking? Quit it cold? Taper off?

I am taking nortriptaline 30mg for migraine 2 days now. Having rapid heart beat after taking. Shall I continue taking? Quit it cold? Taper off?

Sounds like: You are having adverse rxtn to the nortriptyline, and the dose you are taking is far too low to really prevent future migraine headaches. If you increase dose, you will have more problems. There are far better prophylactic options, and it is best to find a headache specialist, and consider other meds or even otc preps which are safer, more effective, and have less side effect potential.

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As a migraine sufferer. I have tried propranolol, amitriptyline, nortriptyline, toprimate and currently on sanomigrain. What would you suggest next.

Migraine treatment: Once a diagnosis of migraine has been made, effective management of migraine involves three specific strategies: 1) patient education, 2) nonpharmacological management (e.g. acupuncture), and 3) pharmacological (medical) management. See an orofacial pain or headache specialist for evaluation and professional management.

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Is nortryptyline a good medicine for derealization caused by migraines and also anxiety? How long do I have to be on it to know whether it helps?

Is nortryptyline a good medicine for derealization caused by migraines and also anxiety? How long do I have to be on it to know whether it helps?

Anxiety: It has a good chance of helping with anxiety. If your derealization is related to your anxiety, it has a good chance of helping with that as well. But it is dose dependent. You may need to be on it for a few weeks to know -- again, dose dependent. It is possible that yoo will get no significant side effects, but discuss this with your prescriber.

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Started having dreams since taking nortripline for migraines. Will they alwsys be there?

Maybe: Some side effects from meds such as nortriptyline wear off and some dont. Also, sleep cycles change over time, so it is difficult to predict whether your dreams will always be around. Only time can tell.

Dr. Alan Ali Dr. Ali
1 doctor agreed:
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As for migraine attack is zomig (zolmitriptan) 2.5 is effective and what's the dosage of this medicine?

Dr. Alan Ali Dr. Ali
1 doctor agreed:
As for migraine attack is zomig (zolmitriptan) 2.5 is effective and what's the dosage of this medicine?

Zomig (zolmitriptan): Doses of 2.5 or 5 mg. Are effective for such headaches. Total daily dose is as recommended by your neurologist.

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What dosage do you expect toprimate to start working for migraine preventative. Will they help reduce pain of migraine.

What dosage do you expect toprimate to start working for migraine preventative. Will they help reduce pain of migraine.

Different: Everyone is different in their response to topomax. Usually by 100 mg a day you should see a decrease in the number of migraines. As for the pain intensity of the actual migraines you still get… no data regarding if it helps the intensity.

Dr. Bennett Machanic
1,487 Doctors shared insights

Migraine Headaches (Definition)

Migraine headaches are a common condition that often include a headache with throbbing, pulsing pain, blurriness of vision, nausea, and sensitivity to light. They ...Read more


Dr. Dariush Saghafi
1,870 Doctors shared insights

Migraine (Definition)

A type of headache that is associated with throbbing localized pain and usually causes light ...Read more