The Vestibular Migraine Community

Anyone have success with nortriptyline?


So I have made a slow transition with my medication from topamax to nortriptyline. The reason I failed topamax was it caused insomnia which is really unfortunate because it was working so well. Currently I am on 40mg of nortriptyline and 25mg of topamax and since I have been weaning off topamax my daily dizziness has come back. I was wondering if people had success with nortriptyline and about how long till you should start seeing results. I have been on it for a month and just got to 40mgs. I am sleeping a little better so I am still going to stay on the 25mgs of topamax becasue i know it helps.


Hello dizzydad. I can only tolerate 10mg of nortriptyline but that knocked the 24/7 nausea on the head in 12 hours. For all the other symptoms I have 12.5mg topiramate in the morning and 12.5mg in the evening. At first my sleep was disturbed but now I sleep a straight 7 hours usually and then go back to sleep for another hour or so. I have occasional break through mild dizzyness when I am really stressed, but I can do my housework, chop Vegetables wash my car, reach up and down into cupboards etc which I could not do before without major nausea and virtigo. So the combination of low doses of both meds works for me. I walk miles every day, deliberately challenge my balance, make a point of watching fast moving things on TV which I used to close my eyes to avoid, all in the hope that my brain will one day cope without meds but meanwhile I am very grateful for them. If topiramate works for you the addition of nortriptyline should help with sleep, just keep the dose low and maybe split the topiramate like I do or even just take it in the morning?


I gradually moved up to 100mg of Nort after being on 100mg of Meclizine for last 16yrs…Meclizine started giving me terrible side effects. I’ve probably been on 100 mg of Nort for last 4 months and doing great…thank God. i hate to say this but I was at the end of my rope…I had enough if you know what I mean. One of the most important pieces of advice I can give is to be patient and give it time.


Quite a few on Nort. I continue to generally improve on its cousin Amitriptyline. I keep the dose at 20mg. The higher you go the bigger the impact on your gut which is the biggest longer lasting side effect I find.

I still get breakthrough symptoms some days and I’m convinced there is a physical root cause to those but I’m getting much much better at handling those psychologically. Luckily I have some almost normal days now so it’s easier to shrug off the bad ones knowing a good day will come.


I have been mainly on Nortriptyline since I was diagnosed in 2014. My neurologist thinks I should be taking 75mg a night, but I’m finding that 30mg is causing side effects (disturbed sleep, nightmares and intrusive thoughts) It has never helped with my sleep inertia, so to combat that I take 5mg Prochorlperazine a night, which helps me get up in the morning. I wonder if your specialist would prescribe you both if you can find a tolerance that works without nasty side effects. Good luck!


That’s great to hear. how long did it take you to get up to 100mgs? I am trying to move up 10mgs every 2 weeks. I’m glad to hear you are doing well!!


iam now on 60mgs of nortriptyline and im having some better days YAYYYY I also still have some crappy days but nortriptyline got me better last time and im sure its going to do the same this time :slight_smile: hang tight this does take time!


Weegrumpy, consider a switch to Amitriptyline which is more sedating than Noritriptyline so should be better for sleep:

I only have issues with sleep when the underlying symptoms of MAV overwhelm.


I would say it took about 6 months to get up to 100mg. Dr says I can take more if needed…125mg to 150mg per day. I am also taking 60mg verapamil which also seems to help…it’s a good combination for me. Once in a while I sneak in a little meclizine on a bad day and thankfully It doesn’t give me bad side effects on low doses.


Hey so I am on 40mgs of Noritriptyline and have been having chest pain off and on for the past three weeks. I have been to the doctors twice for a full cardiovascular check up and they have told me that the Noritriptyline is not effecting my heart in any way which is good. I’m curious has anyone else dealt with chest pain and discomfort from taking Noritriptyline? I know its a known side effect and i hope is just calms down as my body adjust to the drug. I feel like my anxiety is causing a lot of the pain as well. I am so frustrated with the side effects of these drugs. The drugs i have been taking work for me i just can’t handle the side effects so annoying!!!


I started on nortriptyline 10 mg/day in July 2015 after being diagnosed by Dr Surenthiran. It helped alleviate my symptoms of MAV almost immediately. Since then I have titrated up to 75 mg/day, which I have now been on for several months.

The nortriptyline has greatly improved my symptoms without completely eliminating them. Dr S. added pizotifen 1.5 mg/day at my last check-up but I haven’t noticed any effects from that at all (neither improvement nor side effects).

The only bothersome side effects from nortriptyline have been dry mouth, constipation, and intense dreams. The first two can be alleviated with various products, but the intense dreams persist.