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Medications & Prescription Treatment

Notriptyline

  • By Cyndi

    Good morning all,
    I’ve been suffering with intense migraines for the past three years. Lately it’s been happening more often than normal, like 10 a month. I’ve switched PCP (Primary Care Physician) to help me with my migraines. The new dr has put me on Nortriptyline 10mg/BID at night. (I take two at bedtime). Yesterday I had killer migraine that I had to take my Fiorecet three times yesterday along with phenergen. Well when I went to bed, I thought I would take the Nortriptyline. I woke up feeling great! I know it’s day one but have any of you taking this type of therapy? Did it help? I’ve done my research and it says it causes weight gain? Has anyone had that? Any other side effects you’ve had taking it?
    I’m allergic to all “Triptan-based” (Imitrex, Axert, Treximet, Frova, Amerge, Relpax, Zomig, Maxalt)drugs along with DHE. It has the reverse affects on me and my migraine goes up a ten fold!!! I projectile vomit and my head feels like its gonna blow off my head, hurts beyond repair!! No lie. Any information would be greatly appreciated. Thank you!!! Have a nice day!!

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  • By Nancy Harris Bonk Moderator

    Hi cynnewie75,

    We are so happy you are here! I think you will find lots of support and information here. Let’s see what information I can provide you with.

    Nortriptyline, brand name Pamelor, is a tricyclic antidepressant that can be used for migraine prevention. One potential side effect is increased hunger but also listed is loss of appetite – always a plus in my book!! I’ve not taken this medication but know others who have and had success with it.

    I wonder if it’s time to see a doctor who is an expert in treating people with migraine disease and headache disorders. Migraine/headache disorders specialists are board certified in headache medicine, who may or may not be neurologists, and take extra courses to stay current on migraine and headache disorder treatments. Let me share a bit of information on what makes these doctors so important; https://migraine.com/blog/how-are-migraine-specialists-different. And when you’d like to look for one you can find that information in this link; https://migraine.com/blog/looking-for-a-migraine-specialist/.

    I’m sorry to say fioricet is not the best option to treat migraine pain. The reason is this opioid medication covers up migraine pain, it does not stop the migraine process – and that’s what we want to do – and that’s what we want to do, stop the migraine in its tracks! There is another abortive medication to try and it’s a Midrin equivalent. Here is information on this medication; https://migraine.com/blog/midrin-equivalent-migraine-medications/.

    Nancy

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  • By ruth39

    I started on it a week ago with a 25mg tab initially once a day and now up to 4 a day. The constant migraine I have had since 11th January has gone. I have not had any face ache or sluggishness. Feel like I am less hungry but also feel generally that have put on weight over the last month of no exercise due to the constant pain. My neurologist started me on it. I do feel great with it and would hope to decrease the dose down to see what the minimum dose is I need as a preventative.

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    • By Nancy Harris Bonk Moderator

      Hi ruth39,

      Thank you for sharing your positive experience with us. It’s always nice to hear what is working for people.

      Wishing you continued success with your treatment plan and do keep us posted, OK?

      Nancy

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  • By Cyndi

    Nancy,
    Thank you so much for your information! I greatly appreciate it and am looking into finding a neurologist that specializes in migraines.
    Ruth39,
    THANK YOU for responding and giving your honest opinion on it. I’ve on week 2 now and noticing my headaches are coming back again. I really don’t want to up my Nortriptyline dosage. I’m hoping the headache is coming back because I’m ovulating. I hope you start feeling better! I have a follow up with my PCP tomorrow to discuss my lab work along with the meds.
    Take care both of you and have a great day!! Thank you so much for responding to my post!!
    Cyndi

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    • By Nancy Harris Bonk Moderator

      Hi Cyndi,

      I’m so happy to hear you found our information helpful. If you decide to go a specialist, please let us know about your experience, OK? And of course feel free to share any other experience with us 🙂

      Nancy

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  • By Brian in TN

    I spent roughly 4 months taking Nortriptyline while still in the Navy in a failed attempt to prevent my daily headaches. It was the replacement for Elavil which generally has worse side effects (primarily making your skin feel as if you have a serious sunburn every time it is exposed to sunlight). I had difficulty achieving restful sleep along with lethargy and mental confusion while taking Nortriptyline without any noticeable improvement in my headaches. It has been too long for me to remember any of the various dosages we tried. Hope you have more success than I did. If you have children in the house you need to discuss this with your PCP as a neurologist warned me that accidental ingestion of Amitriptyline / Nortriptyline can be disastrous for young children.

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  • By ruth39

    had to cut back to 254mg daily due to dry mouth and ECG changes. HAve now had only 9 migraines in the last 4 weeks which is huge improvement, Also exercising a lot which also helps .It is vital to keep these out the reach of children. I am a doctor and well aware of the effects when taken in overdose- accidently or intentionally. All meds should be kept safely out of the reach of children. Also taking magnesium and have cut out all triggers again (never were triggers before but now seem to be after this terrible chronic cycle)

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  • By Cyndi

    Hi Brian & Ruth!!
    Thank you for your response!! I truly appreciate it!! Well I had another episode which landed me in the hospital with two saline bags in my IV along with some heavy meds. I’m still not feeling up to par but feeling better than I was on Monday. My dr has up’d my Nortriptyline to 30mg at night along with Topamax 50mg at night and 25 mg in the morning. Come to find out that the Topamax is increasing my migraines and I’m allergic to it so I had to stop it. UGH!!! I’m at a stand still and don’t know where to turn besides a specialist. I’m hoping my PCP refers me so I don’t have to be lab rat for him.
    I’m a mom to three very active boys and am very active myself. These migraines are bringing me down and I’m not liking it. Although, I’m a fighter and I will push through them as much as I can. Take care you all. THANK YOU SOO MUCH for answering my post!!

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  • By Nicole

    Hi, my name is Nicole, I stumbled upon a migraine article, which lead me to reading and reading and then signed up to this great sight..I have been poking around reading these different forums. Because we are all so different and have different migraines, I’d just like to offer up what I have discovered in hopes that it can help someone else the way it helped me. Here is a little bit about my story:
    I had/have migraines very bad started at age 29 am now almost 38, I have ocular aura migraines and a lot of the time mimmick stroke symptoms. I’ve ended up in the hospital, the ER etc..I have seen a couple neurologist, stopped seeing one of them because I was not satisfied at all. I see a neurologist now who specializes in migraines, in Boston at Mass General hospital. Prior to him, I was put on Topomax which to me, (just my personal opinion) is the worst medicine out there and surprised it is still on the shelves after reading the forums of god awful side effects of that medicine-it is scary. I stopped taking it and at that point was on a personal mission..I thought to myself there are so many natural ways of healing and helping one’s body, vitamins etc…it’s done all over the world..I was so sick of doctors saying hey try this medication, no ok try this medication, oh the insurance company came and dropped off this medication, try these samples..and that is when I realized, this country is so run by and pushed by medication, we are run by pharmaceutical companies, so much money is made by drug companies…I thought why isn’t anyone researching natural remedies. So I did and I did a lot of research. Bottom line is, I stumbled upon ButterBur
    ( PA FREE ), by a company called Petadolex, I have been taking it for 2 years now and my headaches have been cut by 70%. I take 75 mg 2 times a day along with CoQ10 combined with Fish Oil, ( I get it at a vitamin store, they all carry them) take that 2 times a day as well. I also take a Super B complex vitamin once a day. In my case, this has been by far better than any prescription drug, it has helped me more than anything I have tried, and I am not putting all of that medication in my body. I urge others to try it. ButterBur has been used in so many countries for almost a century, and so many other countries push it for migraines, just not our country. I truly hope this helps someone, again it is just my personal story, and what changed my life for the better, it has totally changed my migraine life.

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  • By Ellen Schnakenberg

    Hi Nikki,

    Once again, from my friend Nancy –

    There is lots of evidence that butterbur is effective for migraine. However, when not purified properly it can be very toxic. Petadolex was being manufactured correctly in Eurpoe where it was recommended we purchased it. But the manufacturing process has changed and migraine specialists are no longer suggesting we use it.

    Don’t panic, there are other alternatives. Here is information on this topic from migraine/headache disorder expert Dr. Mauskop; https://migraine.com/blog/boswellia-a-potential-herbal-remedy/. In addition Magnesium, riboflavin, Coenzyme Q10, and other have shown to be helpful. Let me share a link with you on other natural remedies; https://migraine.com/migraine-treatment/natural-remedies/. But before you start other natural supplements make sure you discuss it with your doctor. This is important information on natural supplements everyone who takes them should read; https://migraine.com/blog/safety-of-dietary-supplements-herbs-for-migraine-prevention/.

    Nancy

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  • By GardensatNight

    I’ve been on Nortriptyline for 3.5 months now, up to 30mg at bedtime. I haven’t yet noticed an improvement in the migraines, but on a positive note, I haven’t had serious side effects either. They make me sleep better, which is a plus. Weight gain hasn’t been an issue. My head has been slightly foggier, but not to the point I can’t function. I would say it’s evened out my moods, to some extent, and I don’t feel as anxious, which is a plus.

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  • By Cyndi

    I can’t tell you how much I appreciate each one of your responses! It makes me feel better that I’m not alone in this. Since my last post, I’ve taken myself off of all preventatives and was doing ok. The migraines didn’t get better nor did they get worse, they stayed the same. Although getting off the preventatives, my mind isn’t foggy anymore and I can actually think normal. (If there is a normal. :)) I have seen a neurologist which he tried to place me on some preventative, which did the same as all other meds. They had really no effect on me, my migraines just intensified worse when I did get them & they were hard to get rid of. Just last week, I had my first round of Botox and am feeling ok. I don’t have consistent aura’s and I’ve only had one migraine. Here’s to hoping that the Botox therapy works well for me. Take care all and hopefully you have a pain-free day today!

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  • By skullsnbows

    I took Nortriptyline about 10 years ago as part of a crazy med cocktail. My migraines weren’t as often back then so I don’t really know what effect it had on them. I can, however, vouch for the weight gain. I craved carbs like crazy and put on 40 pounds while I was on it, which I still haven’t lost completely.

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  • By Anthony

    I was just prescribed nortriptyline but haven’t started taking it due to a fear of side effects. I took amitriptyline, which is basically the first gen of this med and had a bad side effect of tremor. They prescribed me 10mg once a day, which is a low dose, but I’m still hesitant to take it. However, I have a headache/migraine every day and it’s ruining my life. My girlfriend of 9 years even separated from me. Anyways, I tried to get a lower dose, but this seems to be the lowest made. I have the capsules. Does anyone know if it’s oaky to open the capsule and dump out half so it’s closer to 5mg? I know this sounds crazy, but I just don’t want to land in the ER with another huge side effect again. Thanks.

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  • By Brian in TN

    awest, you should ask your doctor about this. Having said that if these are capsules that can be slid open then they are designed to dissolve in the stomach, some pills have special coating so they don’t release the active ingredient until they arrive in the intestine. Opening the capsules and removing 1/2 the contents and then resealing the capsules should work fine in any case. Since all psychotropic drugs have to pass through the blood / brain barrier you should start to feel any effects roughly 45 min. after consumption. If you experience ill effects before then it may be an allergic reaction vice a side effect. SAFETY WARNING: if children have access to your home you need to dispose or secure this medicine before they can get near it, Amitriptyline / Nortriptyline can have fatal effects on children and must be handled carefully. Hope this helps,
    Brian

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  • By Anthony

    Hey Brian, thanks for your input. I just asked a doctor today and he said not to open the capsule, but I’m kinda in agreement with you…what would be the harm? It’s essentially just lowering the amount of medication in the capsule from 10mg. Obviously it’s not that accurate though. I’m at a loss of what to do now. I suppose leaving the capsule as-is and just trying the 10mg is best. Argh.

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    • By The Migraine Girl Moderator

      Good luck to you, awest, and let us know how things go. You might also ask your pharmacist about opening the capsule. I would exercise caution any time you’re going to do something against the doctor’s better judgment/recommendation, however.

      Fingers crossed that you find some relief. I’m sorry you’re having a rough time. We’re here to listen any time you need to talk!

      Sincerely,
      Janet G.
      “The Migraine Girl”

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  • By Anthony

    Well, I started the Nortriptyline. I was able to get a liquid suspension form and I’m currently taking 2.5mg, working up to 5mg, then to 10mg. Not much difference yet, other than maybe slightly more tired. I still wake up with headache and have the pain and other weird symptoms all day, for which I’ve been taking ibuprofen just to take the edge off (barely does anything though). Crossing my fingers that this works…please send good vibes my way! Thanks!

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  • By Anthony

    It’s been about 2 weeks on a low dose of Nortriptyline and I haven’t noticed any change in my daily pain yet. Still wake up with the same damn headache that of course, lasts all day. I’m trying my best to stay positive, but this is really discouraging. Hoping there is light at the end of tunnel from all this suffering…

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  • By Katie M. Golden Moderator

    Awest,
    You need to give it more time. I know that’s not what you want to hear. It sounds like you are still on a low dose. Titrating up over the next few weeks as your doctor suggests could prove to be helpful. Once you get to the max dose that you can tolerate, you still need to give it 3 months before determining it is not helping. Your body has to get used to the med. Of course, if you are experiencing unpleasant side effects, let you doc know ASAP.
    -Katie

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  • By Anthony

    Hi Lisa,

    Not much noticeable improvement that I can see. It may be slightly helping my mood, but not with any pain unfortunately. Pain relief is the most important think to me at this time. I am taking 5mg though, which is a low dose, so I will need to get up to a higher dose and for a longer period of time as Katie suggested. I’ve noticed more pain behind my eyes in the morning and throughout the day, which could be a negative side effect of this drug…not sure.

    Have you tried Nortriptyline?

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  • By Anthony

    Hi Tammy,

    Yes, I always wake up with headache. After speaking with my doc, I have stopped the Nortriptyline to see if the morning eye pain subsides. So far (on day 2 of no meds) the eye pain isn’t as intense. It’s still there, but definitely not as bad. I mentioned to her that the eye pain does usually subside significantly after 10-15 min. of being upright and starting my day. Strange it gets better with positional change. She’s not sure why this is, but then again, she is not a neurologist nor a headache specialist. I really was hoping Nortriptyline would work for me. As for my sleep, it is very poor. I mentioned a sleep study, but she did not request one yet. I need to be more proactive in getting the tests that I want. But I’ve already had almost every test in the book…CT, MRI, EMG, eyes looked at, thoracic CT, etc. I’ve had a ton of radiation which I”m not happy about, but can’t go back now.

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