The Vestibular Migraine Community

Effexor how does it work?


Hello, I am new to this forum but not new to MAV. I am currently taking effexor. I was symptom free for 2 weeks and now the symptoms are back. It seams that when I increase the dose and feel better after a short period of time my body adjusts and symptoms come back.

Can someone is able to tell me how does the effexor work on vestibular migraine? I am trying to understand



Unfortunately there is no real specific agreement on how any migraine treatments exactly work

The general consensus for SNRIs like Effexor or tricyclics like Nortriptyline or Amitriptyline are that they bathe your brain in neurotransmitters (Norepinephrine in the case of Effexor) - when it comes to MAV it is believed this neurotransmitter bath either does one of two things:

  1. directly reduces the vestibular system response to the migraines (vestibular suppression)
  2. reduces the migraine severity and frequency, resulting in more time for the brain to compensate from the bad vestibular signals (migraine relief)

Exactly how it works is not known, but in your case it sounds like you haven’t quite reached the correct dosage yet. The goal would be to have enough free Norepinephrine in your system to properly mitigate the symptoms of MAV over a longer period of time than two weeks


thank you so much for your reply and thank you for the explanation … finally :slight_smile:
I am also taking 50 mg of Nortriptyline with the 37.5 mg. Let’s hope is that I just have to increase the dose, this illness is so cruel !!


Keep in mind even with medicines you will have breakthrough symptoms. That is the nature of this beast. Don’t expect meds to make you 100%. Give it more time on the meds and you will see progress. How long you been on the combo of 50 mg of Nortriptyline with the 37.5 mg. ?


I have been on Nortriptyline from July that was helping a little bit but not impressed with it. Added the effexor end of September: I started with 1/4 of 37.5 and builded up to the full dose.
It was instant … from the day I started the effexor all the symptoms were going away and I was 100% most of the days. I guess you get use to being well so quickly.


This is a good question in general. I have a feeling the meds calm the ‘brain panic’ and therefore reduce the perception of dizziness. Not convinced they do anything for imbalance though. Only compensation or healing can do that.

Keep an eye on how much meds you are taking. In the longer term I believe you are best to minimise them to maximise the brains capacity for compensation. But in the short term they may actually assist by preventing migraine state which helps no one.


I didn’t think that an anti depressant acts a vestibular suppressant. My intentions is to try to get off the nortriptyline, it doesn’t make me happy to take so many meds


Thanks for letting me know. I am on Amitriptyline and i have seen a slow and steady way of getting better. Have an unopened bottle of Effexor XR. Is the XR version the one you take ? If the trend on the Amitriptyline continues will not add on the Effexor. Have always wondered if anyone did the Ami/Nort with Effexor combo. You gave me a valuable datapoint.

BTW what is your dosage on the Nortriptyline ?


I am currently on 50 mg nortriptyline, I started with 10 mg in July and builded up to 55 mg.
It help but didn’t take away the constant visual disturbance (visual dizziness) so my neuro otologist added the 37.5 mg Effexor in September. He said I can go up to 75 mg if needed.
It was regular effexor but I started today the XR as the half life of the effexor is so short in the evening I always have some symptoms. My GP thought that we could try the XR. I will let you know in a couple of days how it goes.
I reduce to 50 mg as it was easier to have 2 pills of 25 mg.
I though it’s was little bit of a weird combo but seems to work most of the time.
I am quite stubborn and I will try anything to get better:)


Hey there,
I was reading your post regarding taking effexor and I was wondering how that has gone for your vestibular migraine? I am seeing my doctor this Wednesday and he stated he is going to start me on a prescription with effexor for my 24/7 dizziness that he has diagnosed as MAV…



Hi Pablo,

I am a really happy effexor user, my neurologist started me on 37.5 but at the beginning I was braking the pill in 4 so I builded up over a month to full dose 37.5.
I am 98% now, this was nearly instant when I reached half dose of effexor. I had some bad days but mostly good. I had some symptoms in the evening so my GP gave me the Effexor XR and since then no more symptoms in the evening.
I can feel that I am not a 100% but I can’t really say why. The 24/7 is not there anymore and this really made me happy.
Yesterday I went shopping in a supermarket and it was a little bit off but not as bad as it was before. For that I will start doing VRT next month
I just hope it lasts, if it doesn’t I will increase the dose
Let me know if you want to know anything else


This said… today I am having some symptoms but yesterday I was doing too much