Elavil/Amitryptaline

I was experiencing bad vertigo with my migraine so was prescribed the above as a preventative (10mg to start at bedtime). I've been on it for exactly one month today. At first I was seeing no relief from the 10mg (on it for a week at this point) so doctor recommended 20mg (on it for 2 weeks). The dizziness disappeared but it made me feel like a zombie all the time even when I took it 2 hours before bed. I was then told to try 10.5 mg which I've been on for a week. I feel better mentally during the day (no zombie) but the past 3 or 4 days I havent been sleeping well at all during the night, I'm restless (especially my legs - like they want to jump out of their skin all the time), nauseous, I'm edgy and just "dont feel right". I also feel out of control a lot.

Over the past 2 months I have missed a lot of work. They understand and have been very accommodating allowing me to work afternoons only but even then it's been a complete struggle. I'm wondering if I should go off the Elavil and hope that migraine vertigo was just a temporary thing. Has anyone else had the same experiences with this med? If I decide to go off, do I need to wean slowly? It's a pretty low dose so not sure if I have to worry about any withdrawl effects. Any comments or suggestions are appreciated.

I take 75 mg. Over that I turned into a zombie. I have no side effects--just sleep well. I have forgotten to take them with no side effects so I think you should be fine.

It may be that your body just needs some time to adjust to the medication. I would give it a little more time.

I've tried a similar medication, nortryptaline. It is a little less effective than elavil, but it also has fewer/lesser side effects. If you give elavil some time, like the preventative effect but not the side effects (SE's) nortryptaline may be a good alternative.

Nortriptaline (NTP) never really worked for me, but before going off I ran a little experiment for fun. I too didn't like the SE's. I found that on days that I ate eggs, that the side effects would lessen. It is believed that a good portion of the side effects from NTP and Elavil result from it's ability act as an agonist of acetylcholine receptors. Well take one guess what egg yoke is high in? .... Phosphatidylcholine (PDC). Guess what PDC is a precursor for? You guessed it, acetylcholine. So I started taking a capsule of PDC every day, and most of the SE's cleared right up.

Now I ended up going off the NTP still, as it didn't work for me as a preventative med. I have no idea if the PDC would lessen the effectiveness of the med for you... but some food for thought.

Good Luck!

I have another idea for you. I know someone who has migraine associated vertigo and they swear by a combination of a high potency ginger extract (made by New Chapter, I believe) and ginko bilboa.

A word of warning about the Ginko Bilbo. Some people find it makes their headaches worse. It also interacts with many medications, so definitely check with your doctor first. I would think the ginger would be pretty safe though, but I guess it's always a good idea to check.

Best of luck!

I've been on Elavil and Amytriptaline for years. No change in migraines at all but the Elavil kept my blood pressure down during attacks (pain can cause significant blood pressure elevation) and Amytriptaline made me sleep like a baby. My new neuro suggested I up the amytriptakline from 25 mg. to 100. I did this slowly. Couldn't get past 75 mg without feeling sleepy all the time so stayed there. I experienced one of the worst migraines I have ever had. The same thing happened when Iw as on Topamax. Preventatives for me may lesson the migraines somewhat but hardly enough to make it worth it. I also worry about the long time side effects of these drugs. I definitely believe that migraines are worse than taking preventatives but since I haven't had that much relief I have decided to go off all of them and see what happens. My abortives work, so I would rather rely on them instead of trying to prevent them all together without much luck.

I ended up in the ER over the weekend because of a migraine (first time in ages) I'm thinking due to the higher dose of Amytriptaline, and I was out of abortives. The ER nusrse said there is no reason I can't get more abortives, so I'm calling my doctor. That will put me at one drug and only as needed with Vicadin occasionally--far better than loading my body with all these pills. I'll let you all know how this fares.

It sounds like you have restless leg syndrome which can be a really annoying side effect of many of these drugs. It also leads to lack of sleep which can trigger migraines. So bit of a backfire. Unlikely that will get better until you switch to a different drug.

A recent editorial in BMJ (British Medical Journal) states that Amitriptylaline has been prescribed as a preventive against migraine for 50 years, with virtually no evidence! The editorial refers to a meta analysis (that is doctors compiling all the data available on a topic) on tricyclic antidepressives and migraine prevention.

The conclusions drawn in the editorial are:

Conclusions that can be drawn from meta-analyses depend on the number and quality of available trials. As the authors rightly point out, the number of studies was not large and most were small and of short duration (average 11 weeks). Moreover, most trials would not meet current methodological standards because 80% (16/20) of placebo controlled trials were completed at least 20 years ago.7 8 As a result, convincing evidence is available for only the most general conclusion: amitriptyline is more effective than placebo for migraine and tension headache. Amitriptyline also seems to be more effective than serotonin reuptake inhibitors, although few direct comparisons are available.

If you only read the publicly available first paragraph (http://www.bmj.com/content/341/bmj.c5250.extract) you get the opposite impression, as it is cut off before the conclusions.

I suggest you talk to your doctor about a reassessment of your medication.

Good luck!

About 10/12 years ago I tried and gave up on Amitriptylene as it made me so tired I couldn't function properly.

However, over the past year two migraineurs I know have been taking it with very successful results, although one of them did put on rather a lot of weight.

So, early in December, I asked my Dr if I could try again. I started on 10mg and after two weeks increased to 25mg. I have to say, that so far I'm very happy. For the first time in years and years I have had nine day gaps between migraines, I can't believe it! I also love the better night's sleep I'm enjoying. I do struggle to get up in the morning but if I continue to enjoy breaks from migraines then it's a small price to pay.

I usually average about 15 migraines per month but I find maxalt almost always works and allows me to live a fairly normal life.

I'm in my late 50s and have been suffering since my late teens. I was told once that they should improve after menopause, but I had that in my early 40s and it's made no difference.

Firstly and just an observation....there would appear to be many more ladies on this site than men....which leads me to the obvious conclusion that the percentage of men suffering migraine with aura is significantly less than women? I am a 60 year old male migraine sufferer since a very young age and like so many people here trying desperately to find maybe not a cure but some relief. Since Monday I am taking 10mg Elavil/Amitriptyline which hopefully will help, so far only a few days in and no headache I understand the logic behind taking an antidepressant as I have come to the conclusion that my migraines are stress related and if I can control the stress then maybe less migraine....I will let you know. When I visited my GP on Monday he said I had increased blood pressure (due to migraine?) and has instructed me to visit him tomorrow. He also advised me to not attend work for a few days, take the elavil/Amitriptyline and see if there is any difference. Hopefully my BP will be more normal tomorrow...

Just a note on the BP, pain of any kind will push up your BP and any triptan medication will also push it up as they are vasoconstrictors.