The Vestibular Migraine Community
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How do you take your medication?


Does anyone split their dose or does everybody always take it once a day? I need to titrate upwards and am considering splitting a dose of 20 mg of nortriptyline into 10 mg at lunchtime and 10 mg in the evening. Does anyone else do this?


20mg Ami only once in the evening around 8:30pm to ensure I can get up betimes in morning. Seems to work. I wouldn’t recommend daytime as has sedating effect which would be annoying at work and definitely rules out driving or use of machinery (the latter doesn’t really apply to me, I’m an IT developer, but I suppose rules out late night DIY!)

On plus side it helps you sleep even when tinnitus is playing up.

My neuro has always pushed me towards 30mg when I complain of breakthrough symptoms but I’ve resisted as I can tolerate the remaining symptoms when they appear and it minimises the side effects. I’ve tried 30mg a couple of times and dizziness got worse rather than better so I felt like 20mg was my upper limit (although if I’d given 30mg a few weeks it might have settled down). Also a lower dose allows you to keep an eye on your condition better I feel.


Thank you James, that all makes sense. I just thought splitting the dose might minimise side effects but maybe not!


I believe the side effects are due to the shared use of the neurotransmitter it inhibits. Unfortunately it is used to regulate the bowel and I find I get mild constipation but that has definitely eased over time. Can only imagine the effect of backing off from the dose. Lol. Ahem.