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Amitriptyline vs Nortriptyline???

Has anyone tried either, or better yet both of these drugs for prevention of chronic daily migraines?
If so, I would love to hear your feedback re: effectiveness, side effects, etc.
Thx!

  1. Hi tbs448,

    Amitriptyline (also under the brand names Vanatrip, Elavil, Endep) and nortriptyline (brand names Pamelor, Aventyl HCl) are both tricyclic antidepressants that can be used for migraine prevention. I took amitriptyline for migraine pain after I fell in 1996. It didn't work for me, but I know many who have good results with this medication. You can read more about amitriptyline here; https://migraine.com/migraine-treatment/elavil/.

    A word about starting new medications if I may. One of the frustrating things about starting new medications is that we may not see results right away. It can take up to three long months before we see a reduction in our migraine frequency and severity. During this time potential side effects may lessen as our body adjusts to the new medication.

    I hope that helps.
    Nancy

    1. Not a doctor. Child of pharmacists and have an amateur interest in psychopharmacology.

      Elavil and Pamelor (because I can't spell the generics right at this moment due to a topamax brain lapse at the moment) are both tricyclic antidepressants so they share most of the same side effects. Pamelor is really only notably better in terms of some drug interactions and cardiovascular side effects. It's still just a good old TCA and most of the weird TCA stuff stays the same. I think much of the reputation for "better tolerability" comes from the better interaction profile.

      All of that said, everyone responds to every med in a unique way and it could be the miracle drug for you so it might be worth trying out. I don't know why it would hurt anything to try, but on that you should get a solid medical licensed opinion.

      1. Reading this post in 2021 and had no idea back when you wrote this comment that there was a community here - I struggled so much with topamax with intrusive thoughts and horrible brain fog, where I could not quite reach my words and thoughts, and they came to me only in slow motion - it felt like such a lonely and isolated time and like I was 'imagining things' so even just the small comment about topamax messing up your spelling, which I had back then, is a cathartic thing.

      2. Hi @brendanjoseph,

        Thank you for sharing this with us. It's so important to know we're not the only one going through difficult times with medications.

        Topamax works wonders for some people, not so much for others. It seems to be a love it or hate it sort of thing. The things you mentioned all too often occur while taking this medication. Sometimes they go away with time.

        Thanks for being here, I look forward to hearing more from you and hope today is a good day!
        Nancy Harris Bonk, Patient Advocate/Moderator

    2. I've used both without side effects. However the amitryptalyne didn't do anything for me and the noritryptalyne has worked as an effective preventative.

      1. Ivan45 and mmjardel, your comments have been helpful. I was on amitriptyline 80 mg every night. It caused me to gain so much weight so fast, I tritated down to 40 mg at night, which is max dose I can take and not have weight side effect. I had some strokes and cardio issues, as well as continued to wake up every morning with major migraine. My headache specialist suggested a switch to nortriptyline. I now understand reasons for change had to do with cardio issues and likely drug interactions. I discovered 40 mg of Nortriptyline brought back side effect of weight gain, so I went to 30 mg. This is working well.

        Thank you for this forum. It provides excellent information from a broad base of experience and helps me know I am not alone in what I experience as a chronic migraineur. The short time I've been a member, I've been better prepared for discussion with my headache specialist and am better able to traverse my course through the world of migraine..

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