Nortriptyline for Migraines: Does it Work?

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Nortriptyline for Migraines: Does it Work?

Migraine is pretty tough to treat. Finding relief can be so difficult that over a million emergency room visits are attributed to migraines every year. Since migraine eludes many of the straightforward treatments, researchers are on the lookout for less obvious alternatives. 

For example, 85% of users have seen their headache days reduced by one-third by wearing migraine glasses. Another out-of-the-box treatment is to use nortriptyline for migraines. 

In this article, we’ll talk about what nortriptyline is, how it’s used against migraine, and the potential risks, so you can make an informed decision with your doctor.

What is Nortriptyline?

Traditionally, nortriptyline is used as an antidepressant. It’s sold under the brand names Sensoval, Pamelor, and others, and falls under the category of tricyclic antidepressants, or TCAs. It comes in both pill and liquid form. 

In the case of depression, they work by acting on neurotransmitters or “messengers” that send communication between brain cells. Essentially, tricyclic antidepressants alter brain chemistry to regulate a person’s mood and ease depression.

Why is Nortriptyline Sometimes Used for Migraine?

Serotonin is a neurotransmitter with the main function of stabilizing your mood and making you feel happy. Since happiness and migraine don’t really go together, this shouldn’t come as a surprise that serotonin levels drop during a migraine attack. 

In fact, depression and migraines often occur together, with some patients actually feeling depressed before the migraine comes on.

One theoretical cause of migraine is neurotransmitters like serotonin that are out of whack. Some research indicates that antidepressants like nortriptyline, which balance or boost serotonin levels, may help prevent migraine attacks in the first place.

However, it seems this research is still up for debate. A more recent study found that serotonin levels are indeed involved in migraine pathophysiology. But it contradicted earlier studies that linked low levels of serotonin receptors to migraine. Instead, this study found a correlation with higher levels.

Nortriptyline for migraines is an off-label use of an anti-depressant drug

Side Effects of Taking Nortriptyline for Migraines

Tricyclic antidepressants have several side effects, so before taking nortriptyline for migraines, it’s important to understand the risks. 

Nortriptyline has several other side effects which are more common, including:

  • Anxiety
  • Trouble sleeping
  • Nightmares
  • Appetite and weight changes
  • Constipation
  • Changes in urination
  • Dry mouth
  • Excessive sweating
  • Sex drive changes
  • Fatigue
  • Muscle weakness
  • Upset stomach
  • Drowsiness 

Nortriptyline has also been linked to side effects which constitute a medical emergency, including:

  • Suicidal thoughts
  • Worsening depression
  • Irregular heartbeat / palpitations
  • Speech changes
  • Spasms in the jaw, neck, or back
  • Shaking
  • Fever
  • Yellowing of eyes or skin
  • Rash
  • Shaking
  • Shuffling while walking

You should also know that the FDA has actually given nortriptyline a Black Box warning, which is the strongest warning they issue. In the warning, the FDA notes that this drug could actually worsen depression in kids, teens, and young adults. This can bring on major depressive disorder and elevate suicide risk.

Nortriptyline carries an FDA black box warning. Nortriptyline for migraines should be used carefully.

Is Nortriptyline for Migraines a Useful Preventative?

Many patients report that taking nortriptyline for migraines is helpful. According to reviews reported by Drugs.com, 77% of users reported a positive impact. But what does the research say?

Clinical studies have shown that nortriptyline for migraines can significantly reduce the frequency of attacks. If you get migraines frequently, you might want to talk to your doctor about whether nortriptyline or other tricyclic antidepressants could help you. If so, it could help you reduce your dependence on pain medication.

Make Sure the Pros Outweigh the Cons

If you struggle with depression, taking nortriptyline for migraines could help you manage both conditions. In this case, the benefits of taking nortriptyline may outweigh the risks. However, whether that’s right for you is between you and your doctor. 

Nortriptyline won’t be the right course of treatment for everyone. If you have a history of major depression, for example, your doctor could have major concerns about prescribing you nortriptyline due to the potential for increased depression and suidice risk.

Nortriptyline for migraines is often a go-to treatment even for patients without depression. The effective dose for migraine is usually lower than the dose for depression, so people who aren’t depressed likely won’t need to take as much. But again, whether or not it’s the right thing for you is a decision only you and your doctor can make. 

Other Alternatives for Migraine Treatment and Prevention

Of course, you have plenty of options when it comes to managing your condition, including medications and natural remedies.

Acute Pain Medications

Prescription migraine drugs like Troadol, Demerol, sumatriptan, and a long list of other medications are designed to relieve migraine pain after onset of the headache. Over-the-counter medications like Excedrin, naproxen, ibuprofen and acetaminophen are also commonly used.

Preventative Pain Medications

If it’s right for you, nortriptyline could help reduce your migraine attacks. But there are a number of other medications that are also FDA approved for migraine prevention. 

From prescription pills like Corgard, Cardizem, and Toprol XL to Botox injections, you and your doctor can decide what works best.

A Migraine Prevention Lifestyle

Your lifestyle could make a big difference in the severity and frequency of your migraine attacks. Here are just a few tips that could help.

  • Keep a migraine diary of your diet and activities to help you identify your triggers
  • Avoid high-nitrate foods like processed meats
  • Get adequate magnesium through diet and supplements
  • Manage your stress levels
  • Get plenty of sleep
  • Exercise regularly
  • Drink plenty of water

Summing Up

Migraine is a neurological issue which is complicated to diagnose and treat. While nortriptyline could very well help you manage your condition, there is no one-size-fits-all solution. Along with its benefits, nortriptyline could have serious side effects. 

Get your doctor’s advice about your condition, medications, lifestyle, and non-invasive tools like Axon Optics migraine glasses to find the best course of action for you.

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