How Do I Use Nortriptyline for Migraines?

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.