Nortriptyline withdrawal questions

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I have a disorder caller migraine associated vertigo (MAV) or vestibular migraine (VM).  I was given nortriptyline for the vertigo and headaches that I have.  I"m dizzy as probably most you know if you have this, dizzy 24/7.  Well I started on 10mgs of nort about 7 weeks ago and was at that does for 4 weeks, then the doc said to increase to 20mgs, which i did about 21/2 weeks ago making the total time on this crap about 7 weeks.  Well when I increased to 20mgs after about a week I started to notice this panicky shaking feelings inside me and I called the docs office and they said that because I had been sick the same week this started it could have been a mixture of the cold meds and nort, so to try it for another week and see if I adjust to it.  I tried it and it got worse, so they said to go ahead and drop the dose back to 10mgs and see how that works out, but I would need to give it a couple of weeks.  Well I started the decrease last thursday night and its now been 4 days on the 10mgs,b ut in the past 2 days I've noticed increased dizziness which i expected but I'm also having anxiety attacks.  I'm wondering if anyone who has decreased or come off this med noticed their anxiety got worse for a bit while the med lowered it self in your body?  I know that with MAV anxiety is part of it.  I have generalize anxiety and realize it could also just be me worrying about the dizziness that I feel and wondering if the anxiety is going to come back that I had before starting the nort.  Its all confusing since there are so many variables in this.  Thanks for any help

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  • Posted

    Hi there,

    I am also on Nortriptyline for MAV/VM and have been on it for about 5 months now, currently on 40mg per day. I find that it helps with my headaches and also with the dizziness, but does not eliminate all of my many symptoms. Because I feel a little better on it though, I have continued on the drug. When I first started it I felt really shaky, had dry mouth and eyes, constipation and felt quite tired. These symptoms have thankfully subsided, though I do still get the dry mouth and eyes. It is one of those drugs that they suggest you give a good 3 - 6 months for it to work into your system and to take full effect. So it may be worth sticking with it for another month or so to see how you go. The side effects do lessen after a while. I think anxiety is all par for the course with this illness, it seems to go hand in hand with most types of migraine and chronic headache conditions.

    Take care.

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    • Posted


      Thank you so much for responding.  I'm now trying to go back up to the 20mg.  I was getting increased dizziness every afternoon between 3 and 5 and going through the evening everyday, so even though I had tried the 20mgs for two weeks about 10 days ago, my doctor suggested to take a pill in the morning also to see if it would carry through the day.  So I've started that today, of course because of my anxiety I have a new sensation and I panic and immediately blame the increased dose, but Ive only been on the additional 10mgs today.  But had a strange feeling happen and anxiety has set in.  When you increased doses did you notice more sensations of dizziness?  I don't know if this med is working.  I mean i decreased the dose and the dizziness gets worse, that makes me wonder if its like a withdrawal sign and will this happen when coming off of it later.  Im so afraid of meds I have a hard time with them and staying on them.  I'm trying very hard to push through this and give it a chance.  Ive been on the 10mg for 2 months and not really any change.  When did you start to notice changes in your dizziness?  Thanks for your help.

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  • Posted

    Yes, every time I've lowered the dosage, I've felt (looking at my journal) that I start feeling the withdrawl either immediately or within two weeks - I think immediately if it's a big drop in dosage - increased anxiety, headaches, fast/slow heart rate, but this subsides.

    Am currently down to 6.25mg, and eager to get off the drug completely as it's raised my resting heart rate from 63bpm to 73.

    Historically, I started on 10mg in July for a week, 25mg for a month and 35mg for a week. After having palpitations (A few episodes lasting a few minutes), I went back down to 25mg. When I felt the condition I was treating (head pressure/discomfort) with nortriptyline got better at end of Sept, I started an aggressive taper going down 2.5mg a week down to 6.25mg. Went back up to 12.5mg as I generally felt unwell and was on this for 5 weeks before trying to go back down again. These 5 weeks at 12.5mg were probably the best 5 weeks I've had since taking the meds. Took 6.25mg for two weeks and stopped completely for a few days. Again, the withdrawl was too much for me so started taking 12.5mg again. Was on this for 4 weeks but felt palpitations again - had about 5 episodes but these lasted hours... I am confused at why this dose that had made me feel so well for me in Nov was suddenly was giving me issues. It was at that point that I realised that I must persvere to stop. I then dropped to 6.25mg. It's been exactly two weeks since the last drop and I've had just had a headache most of this weekend and increased head pressure and anxiety. Will try and stick at it for a little while before dropping again. Also this month started using cbd oil where and when I feel I need it.

    That's just my experience, hope things go well for you.


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    • Posted

      Hi. I was on 37mg for 2 years which I took for lower back pain.

      I started weaning off In August and I'm now (November) on 10mg. It's getting really difficult and the side-effects are getting really bad including flu symptons, insomnia, poor sleep, busy dreams and constantly feeling tired. Apparently the worst side-effects are when reaching 10mg or less.

      No one ever warned me how bad this drug is! It was so easy to start taking it but I never expected it to be so hard to get off it! I probably have another 3 months to go before I am completely free of this drug. I'm now using small amounts of Zopiclone to fight the insomnia. However I am trying to avoid taking Zopiclone every night to prevent getting addicted to that medicine.

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