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Endep/Elavil: How soon does it begin to work?

Hi, I'm a 56-year-old male whose migraines in the past year or so have transformed from once every year or two to 1-2 a week. I have an MRI that showed no problem; tried propranolol (beta blocker) with no great success and now am on Endep (Elavil). I've been on it a week, and had another migraine today. The gap since my last migraine is nine days ... in the past few weeks they have been down to four days apart.

Have others on this medication found it brought immediate relief as a preventer or did it take time to work? How successful has it been as a preventer? Very interested to hear others' experiences with this one.

  1. Amitriptyline (Elavil) has a very strong record as a migraine preventive and works great for many people. How long it takes to notice an improvement depends on the person and the dose. Some people report a change in a week, but it can take three months to see the full effect.

    1. Sadly, Amitriptylines' very strong record as a preventative means it helps roughly 10% of patients, and yes this is as good as it gets. While I can't tell you how long it might take because in the 1 month I tried it I received no relief and switched to Nortriptyline to reduce side effects, does sunlight make your skin feel like your burning, exposing already sunburnt skin? The 6 months total I spent on the 2 didn't relieve any symptoms. You should know however that a neurologist in Jacksonville, FL warned me about keeping Elavil away from children, in the 3 cases he had been called in to consult all 3 children died from complications related to Elavil ingestion of only 2 or 3 pills.

      1. I took Elavil back in the 1970sfor quite a while and it didn't help at all. Now I've been on it again since last Fall at 3x the dose and it still hasn't been helping the migraines at all, but I sleep well at night.

        1. Thanks to all. Ten months after writing that post, there have been some developments. In July 2014 I began attending the Melbourne Headache Centre ( which treats patients on the theory that migraines in many people are caused by an overactive brainstem. This involved twice-weekly half-hour consultations which involved manipulating the C2 cervical vertebrae in my neck as well as specific neck stretching exercises several times a day. At that stage my migraines were recurring at intervals between 3 and 6 days.

          In September I ceased using the Endep (Elavil) in order to assess whether that Headache Centre treatment was having any impact. After a month the headaches were retreating to about days apart. In late October I opted also to abstain completely from wine (I still drink beer)> Since then I have had only three migraines, with the last one now almost seven weeks ago. The last few have been quite mild, rarely developing into anything at all once I take Imigran at the onset of the aura.

          I think the neck treatment (and work on my posture and neck pressure) contributed, and probably the absence of wine has also had a major impact. Then again, who knows? But I am convinced that neither the Endep nor the beta blocker had any preventive effect at all.

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