Nortriptyline For Migraines, Insomnia...

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JaneCat Says:


I just started 25mg nortriptyline for migraine prevention. I was previously on amitriptyline for them and it worked so well, but I was a zombie, couldn't wake up in the morning and had gained 10 pounds. I was always hungry and never felt full. I am hoping that the noritriptyline will have less side effects (at least that's what my doctor tells me).

Day 2 of not sleeping. I take the pill before bed and that must be the problem. Does anyone take it in the morning? I'm a little worried that taking it in the morning will still keep me up that night.

Also, is 25mg a little high for a starting dosage?



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Verwon Says:

Hello, JaneCat! How are you?

As to your starting dosage, you're not actually starting, you're just switching from one to the other, so you'd not start it at the same dosage as someone who is new to taking any of these types of medications.

The FDA lists the typical side effects of Nortriptyline as possibly including nausea, dizziness, sleep abnormalities and weight gain. Weight gain is actually a pretty frequent occurrence with this one, so I am not sure if that is going to change for you.

Does anyone have experience taking this?

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Mia Says:
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I was prescribed Nortriptyline 25mg at night (green/white capsule) to help with depression/anxiety and sleeping at night and a bonus to help with Migrains!!
1st of I'm very sensitive to meds And I will feel nearly every side effect so it's better not to take anything.
With that being said, with Nortriptyline has been easy going and only side effect is the Dry Mouth and I can tolerate that so I was super excited, finally I can tolerate a med.
It's been about 7 months and I don't think it's helping with my problems, other then I don't produce many tear and cry. My dr said I can up the dose to 50mg a night and for some reason I've been up all night, can't stAy asleep.
Btw I still have Migrains, diddnt help with that, I have gained weight, doesn't nothing for the anxiety so dr gives me Ativan for that.
I'm really frustrated. Any suggestions or feedback on your experience with Nortriptyline, would be appreciated.

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DrJoeyMDPhD Says:

Research shows 5- to 10mg BID for migraine prophylaxis. My mentors wife is a psychiatric social worker and she (as always) started nagging him about this NEW drug for migraine prophy. WE both are long-term migraine (or "Migraine-like") suffered and he called me and asked me to accompany him to the Dept. of Psychiatry that he and a now-deceased colleague founded decades ago. Hev got the Red Carpet Tx. Me? They just wanted to make sure I had an MD. I told them I had an MD and a PhD. No sense in working hard if sub-specialists do this all the time, so I created as search string. When the dust cleared, the disagreeing came up as 5-10mg BID. You're right that preventing migraine is NOT like treating Major Depressive Disorders, 5- to 10mg BID; if it doesn't work in a week or so, forget it. It worked for my mentor and his daughter at 10mg BID but no results from me. You're right in your statement that 25mg BID falls in the sub-therapeutic range for antidepressant therapy. (Average daily dose is ~150mg QD). If it doesn't work for migraine prophylaxis but one week on the higher dose, its not going to work.

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DrJoeyMDPhD Says:

Even if it WERE a starting dose, it is NOT HIGH AT ALL. Elavil and Aventyl — 250g/day is a low dose and no problem to start a patient at, except in REAL children, where I''d do my best to start with 10mg qAM as a starting dose.

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DrJoeyMDPhD Says:

That should have been 25mg DAY — I hit the O instead of the "m"

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