How Do I Use Nortriptyline for Migraines?

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  • Written By: S. Berger
  • Edited By: Shereen Skola
  • Last Modified Date: 17 October 2019
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Nortriptyline is a medication belonging to the family known as tricyclics, used to treat migraines, as well as depression and other mood disorders. Doctors sometimes recommend this medication for these headaches, although the drug is not specifically designed for this use. Little research exists on nortriptyline's efficacy for this purpose, but it is chemically similar to another medication, amitriptyline, that is given more frequently to reduce migraine headaches. For this reason, it may be taken as a preventative treatment measure.

Patients wishing to use nortriptyline for migraines should typically meet with a doctor or medical professional to discuss a treatment plan. A medical professional can determine if this drug's mechanism of action will be of more benefit than other migraine medications for a particular individual. A variety of choices are available and should be considered carefully, along with possible side effects and interactions with other patient medications.

Taking nortriptyline for migraines should, in theory, be effective even in patients without mood disorders, even though they are classified as antidepressants. This drug indirectly increases the action of the neurotransmitters serotonin and norepinephrine, in turn constricting blood vessels. Dilated blood vessels in the head are associated with migraines, so keeping them constricted may help to reduce the frequency with which migraines occur.


The limited research regarding nortriptyline for migraines suggests that it may not be as effective as amitriptyline or other drugs. Studies involving patients taking 20 milligrams (mg) per day found that this drug did not reduce migraine frequency for most patients. Combining nortriptyline with 40 mg propranolol, a blood pressure medication, did provide some patients with relief from migraines, however.

Vestibular migraines, a subtype of these headaches, can cause symptoms aside from pain, such as dizziness. A study involving patients taking nortriptyline for migraines of this type showed some symptom relief. Around 46 percent of patients taking this drug saw a reduction in dizziness, if not in pain. Taking another medication, topiramate, with the nortriptyline resulted in a greater alleviation of symptoms.

Individuals starting on a regimen of nortriptyline to treat their migraine headaches should be aware of potential side effects from this drug. Adverse effects commonly include nausea, gastrointestinal distress, and occasionally rebound headaches, although none of these effects are serious, and often disappear after days of treatment. Medical assistance should be sought if more severe side effects occur, such as suicidal thoughts, confusion, or changes in heart rate. Most patients tolerate this medication well, however.


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Post 5

I've been taking 10 mg. of nortriptyline (prescribed by my neurologist) for a week and the weather has been muggy and rainy this past week. During this kind of weather, I would usually at least get a mild migraine and I have had zero migraines or headaches and don't even feel like one is coming on at all.

I have very few side effects and since I have insomnia anyway, I take this at bedtime although it has actually had a reverse effect on me a couple of times, but it mainly makes me drowsy but able to stay awake the next day. It also gives mild dry mouth, but I'll take that over migraines.

I tried Topamax, but that

made me way too tired (slept the entire next day and I took it at midnight) and I quit it after a couple of days, plus it has some terrible long-term potential side effects like it can cause kidney stones.
Post 4

I'm on 30mgs. I used to have headaches every day and migraines that would last for days and weeks. I've been taking it for one month and have only had about five days of headaches and one migraine. After my first dose, I woke up the next morning with no headache. I couldn't remember the last time I had felt that. I would think that if it hasn't worked at all, then it's not going to.

Post 3

@feruze-- I'm on 10mg but I know people who are on a daily dose of 50mg and higher for migraines. You just started it, so give yourself a few more weeks. It might be taking some time to show its effects. But don't increase the dose on your own because it can cause some bad side effects.

Post 2

@feruze-- I'm on 25mg/day and that has been enough to prevent migraines so far. I guess this medication doesn't work for everyone, otherwise, I think it would have worked for you at 50mg. You should talk to your doctor. He might want to add another medication or adjust the dose.

I've had migraines for the past two years and nortriptyline is the only medication that works. It makes me a bit sleepy, but I don't mind that because I usually don't get enough sleep. I take my dose at night and fall asleep soon after.

Post 1

Is anyone on nortrityline right now for migraines? What dose are you on?

I started taking this medication last week, I'm taking 50mg per day and so far, it hasn't helped at all. I'm just wondering if nortriptyline has effectively reduced migraines for anyone and if so, at what dose?

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