Hello and welcome! Many of the members of this forum live in the UK (where it is the middle of the night right now), so I’m sure you’ll hear from some of them tomorrow.
I’m sorry that your husband is suffering from this but glad that you found us.
Your husband’s reaction is similar to what many of us thought, too, the first time someone said “you probably have vestibular migraine.” I know I thought that was crazy. That’s because we all think of “migraine” as a headache.
Migraine is not just a headache. What they’ve found over the past 20 years is that migraine is a collection of symptoms that are all the result of some sort of neurological disturbance. (I don’t think anyone knows quite what that disturbance is, at least not yet.) Migraine can cause dizziness WITHOUT a headache. It can also cause visual disturbances, like squiggly lines in the field of vision, without a headache. There is even something called “abdominal migraine” which, again, can occur without a headache.
And what they are finding is that many drugs that affect the brain in some way work to help prevent migraine in many patients. Antidepressant-type medications sometimes work. In patients where they don’t work, anticonvulsant drugs can work. Sometimes even beta-blockers (usually used for heart conditions) can work.
Please tell your husband not to be afraid of the nortriptyline. Yes, it’s classified as an antidepressant, but it’s used for many other things and this is one of them. Many of the members here take either nortriptyline or a similar drug called amitriptyline.
Unfortunately, with neurological conditions that are defined only by symptoms (in other words, there is no “test” for vestibular migraine), the drug treatments are all trial-and-error. You try one, and if it doesn’t help after a period of time (usually a number of weeks), then you stop that drug and try one from a different class. Usually they start with a drug from the antidepressant class and if that doesn’t work they move on to the anticonvulsant class, and so on.
The dosages of most of these drugs are much lower for treating vestibular migraine than they are for treating other illnesses. The dosage of nortriptyline that they will give him, for example, is most likely going to be much lower than the dosage that would be given to someone if they were being treated for depression. And generally they start someone with a tiny dose and move up from there if the patient tolerates the tiny dose. So there’s not much risk in giving it a try.
Our moderator, James (@turnitaround) has created a welcome post and several of us contributed to the pages contained in that post. I suggest you start there:
Welcome to mvertigo!
https://www.mvertigo.org/t/welcome-to-mvertigo/11943
There are two experts on vestibular migraine, Dr. Timothy Hain in the United States, and Dr. Surenthiran in the UK. Dr. Hain has an excellent website that he created for other doctors (and patients). Start on this page from Dr. Hain’s website:
Migraine Associated Vertigo (MAV) – and the subset called Vestibular Migraine (VM)
http://dizziness-and-balance.com/disorders/central/migraine/mav.html
Dr. Surenthiran is in the UK (London area, I believe) and many of the members here have seen him. Here is a thread where some members talked about him:
https://www.mvertigo.org/t/dr-surenthiran/2758
One thing we have ALL found is that there are only a handful of specialists who know and understand this condition, and it’s best to try to go to one of those specialists if it’s at all possible. Most other doctors don’t have a clue. (My primary care doctor said, “Vestibular migraine? What’s that? I’ve never heard of that,” when I told her that was what I had been diagnosed with.) If you can tell us where you are located we might be able to point you toward some specialists in your area.