The Vestibular Migraine Community

Having a hard time finding the right med


I’ve been put through the ringer these last few months with trialing drugs. I’ve tried Lyrica, Metoprolol and Amitriptyline for a second time without much luck. Without meds I’m mildly functionable (able to drive short distances and get out for a short amount of time, weather depending) but with new meds I end up being just about bed bound. I understand these meds can make us feel worse in the beginning but if it lasts too long without much improvement I start to get depressed which makes it hard to stick with it. I’d really like more of my life back and start working again but trialing these drugs can be rough. I’m starting to get anxious about taking anything now. My doctor’s office said they could call in another med like topamax or depakote but the side effects sound pretty unpleasant and I don’t think I’d last long on those. Since my mood has started to be affected I’m wondering if an antidepressant would be a better choice. Have people found a SSRI helpful for this? Could nortriptyline work even though amitriptyline didn’t or are they too closely related? Same thing with gabapentin if lyrica didn’t work. I’ve wondered if trialing a new drug would be easier if I felt worse. Trying to figure out what direction I want to go in before my next doctor’s appointment. Any thoughts or comments.


I am sure that many here may have experienced similar difficulties finding the right med. So many Meds and each of us react differently to them. I think it helps to not convince yourself that a new med will fail even before you try it. I do like that my Neurologist and I have decided to team up and discuss choices and options and with me being given the final choice.

My first med was Verapamil 120 SR. Worked very well for a month or so but then had many breakthrough symptoms. My dosage was doubled to 240 and within 2 weeks I started having Gum problems that had no obvious reason except for the Verapamil. This is a unusual side effect to have, but sure enough it improved after stopping.

I was given the option of Nortriptyline or Gabapentin. I am on Nort @ 10mg and doing pretty well 3 weeks in. No side effects. Does seem to help with sleep when taken in the evening. I am due to possibly titrate to 20mg soon.

Listen to opinions of fellow forum members but try to decide with an open mind and hope for success.

Good Luck dizzyhead.


I’m new here. Just been diagnosed with MAV by Dr S after 3-4 months of thinking I was dying, due to GPs and Consultants not really having a clue what was going on; Dr S prescribed Pizotifen. Been taking it for a week. I think it’s having a positive effect, although it’s hard to tell as I’m so dopey on it, and I’m due to double the dose tomorrow. Eek. BUT - I have been more stable since I started taking it, still getting symptoms, but without the extremes I was having before. Fingers crossed. Very tired though, and I also think my blood pressure has dropped a lot - although that’s only registered as a side effect of overdose. Hmm. Fingers crossed!


Thanks for the responses! I wouldn’t say that I have convinced myself that a new med won’t work. I had success on Doxepin for over a year with minimal side effects so I know how helpful meds can be. Unfortunately it stopped working and increasing the dose made me feel worse. Didn’t realize switching meds would be so difficult. For example, ended up in the Instacare with a rapid heart rate which all they could attribute it to was a bad reaction to Amitriptyline. There’s nothing like having a doctor say, you’re not having a heart attack but stay near a hospital just in case. Scary! Luckily my heart rate went back to normal as the drug got out of my system. It’s interesting how some drugs work real quick with minimal side effects while others take a while to work and then others just don’t work at all or have adverse side effects. It’s good to hear what meds are helping others. It gives me ideas of drugs to bring up to my doctor, like Pizotifen. Thanks for the reminder about having an open minded with meds. I think I needed that. Definitely hoping for success.