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Medications & Prescription Treatment

Amitriptyline vs Nortriptyline???

  • By tbs448

    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.

  • By Nancy Harris Bonk Moderator

    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;

    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.

  • By ivan45

    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.

  • By mmjardel

    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.

  • By Deb

    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..

  • By Anonymous

    I used Amitriptyline 50mg when I had Mal de Débarquement in 2015. I tritrated up to that over 5-6 weeks and it worked to resolve my symptoms so I assume it was effective for preventing my migraines. I didn’t stay on it because of side effects. I tried Nortriptyline but it made me anxious, so I didn’t get very far on that one.

  • By grandmeem

    with chronic headache was put on pamelor. it did work but i was concerned about yet again another drug. so 5 days before dr’s visit i went off—felt absolutely wonderful til 5th day. symptoms of migraine started, i ignored and by bedtime knew i was in trouble. back to pamelor. not sure if its helpful to be off and on, but it did reduce my headaches by 70%–breakthroughs not as bad as before. so many thanks for this web site