How long does Nortriptyline take to see results?

Ears, nose and throat
1

I feel stupid that I even have to ask this question, but since this all started plenty of doctors have made me second-guess my own experiences and if I’m making things up, so… 

I’ve been dizzy for almost 6 months now. Vestibular dysfunction, tried VRT with no real improvement and my neurologist put me on Nortriptyline. He said it would take about a month to really start working and he’d see me back in two months.

About two weeks into it, I found my limbs were feeling weak and shaky, making walking even more difficult and anything requiring a lot of standing or balancing on one leg very hard. I called to let him know, and he said to keep going since I wouldn’t know yet, I was still adjusting and he’d see me at the end of two months.

Well, it’s over a month (this is my 32nd day) and things keep getting worse. The dizziness is stronger and more persistent, the shaking hasn’t gone away, my eyesight is worse, I sometimes feel like I’m plain going to pass out and all this has given me chronic headaches for the past two weeks straight – I feel like I live on pain relievers. But I’m scared to call the doctor – he’s made it clear, two months.

So… has anyone else taken Nortriptyline for the dizzies? Is one month just when getting better might start and you need to leave it longer to see real effects?

2

Did he tell you that Nortriptyline hydrochloride is used to relieve the symptoms of anxiety/depression? It is a tricyclic antidepressant. This medication is available in generic form. Common side effects include fast heart rate, blurred vision, urinary retention, dry mouth, constipation, weight gain or loss, and low blood pressure on standing.

Note:

Included in the following list are a few adverse reactions that have not been reported with this specific drug. However, the pharmacologic similarities among the tricyclic antidepressant drugs require that each of the reactions be considered when nortriptyline is administered.

Cardiovascular

- Hypotension, hypertension, tachycardia, palpitation, myocardial infarction, arrhythmias, heart block, stroke.

Psychiatric

- Confusional states (especially in the elderly) with hallucinations, disorientation, delusions; anxiety, restlessness, agitation; insomnia, panic, nightmares; hypomania; exacerbation of psychosis.

Neurologic

- Numbness, tingling, paresthesias of extremities; incoordination, ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures, alteration in EEG patterns; tinnitus.

Anticholinergic

- Dry mouth and, rarely, associated sublingual adenitis; blurred vision, disturbance of accommodation, mydriasis; constipation, paralytic ileus; urinary retention, delayed micturition, dilation of the urinary tract. Allergic - Skin rash, petechiae, urticaria, itching, photosensitization (avoid excessive exposure to sunlight); edema (general or of face and tongue), drug fever, cross-sensitivity with other tricyclic drugs.

Hematologic

- Bone marrow depression, including agranulocytosis; eosinophilia; purpura; thrombocytopenia.

Gastrointestinal

- Nausea and vomiting, anorexia, epigastric distress, diarrhea, peculiar taste, stomatitis, abdominal cramps, black-tongue.

Endocrine

- Gynecomastia in the male, breast enlargement and galactorrhea in the female; increased or decreased libido, impotence; testicular swelling; elevation or depression of blood sugar levels; syndrome of inappropriate ADH (antidiuretic hormone) secretion.

Other

- Jaundice (simulating obstructive), altered liver function; weight gain or loss; perspiration; flushing; urinary frequency, nocturia; drowsiness, dizziness, weakness, fatigue; headache; parotid swelling; alopecia.

 

3

He told me it was generally used as an antidepressant and this was off-label use for symptoms like mine or for chronic migraines.  He also ran through some of the more common side effects to say "not to worry" if I experienced them unless they were severe (the hunger, the dry mouth, constipation, nausea, etc).

4

Hi lissibith,

I've not taken nortryptiline but a friend of mine has been on it (the smallest dose) for almost 3 years. She said it took almost 2 months for her to start to see even the slightest of any improvement. I don't recall if she had any side effects. Sounds like your side effects are making you more anxious and causing you to feel more dizzier? Having a vestibular disorder is anxiety provoking enough I know. Perhaps give it a couple more weeks? If you feel worse maybe you need an antidepressant that had some anti anxiety properties included in it, like Zoloft, celexa, Effexor? Are you seeing aneurism otologist? Or just a ENT or neurologist? A neuro otologist deals with both medical aspects and has had training in otolaryngology and neurology. Good luck.

5

I'm sorry neuro otologist not aneurism otologist. There's no such thing and an aneurysm would be detected in a CT scan or MRI. So sorry.

6

I tried it as an off-label use as well and found I was having a lot of what you are experiencing and came off of it.  I took Gabapentin in its place.  Trouble is with a lot of these drugs you can't tell what is the drug causing and what is the VN.

7

I got what you meant, but thank you for the clarification. smile

I'm only seeing a neurologist right now - the ENT said basically there was nothing else he could try.

I don't think the increased dizziness is anxiety-born (or at least not entirely) since I was expecting it at first. When I googled its name + dizziness, I'd seen that a lot of people experienced it for the first week or two, and I've had a couple drugs for other things years ago that made things worse for a week or so before they started to help, so I took the increased dizziness as just the price of eventually feeling better. But then it kept getting worse. So now there definitely might be some anxiety. I never thought a month into a new med, I'd have so much less ability to do even simple things.

8

You're absolutely right sad