Avatar universal

Amitriptyline for Chronic Daily Headache+ Migraines?

Hi everyone,
I have had a continuous headache and at least 8 migraine attacks for the past three weeks. They feel more like spasms shooting up from the back of my head, sometimes pulsates, sometimes jabs, sometimes involve eye pain, and alternates between both sides of my head. I am waiting for an appointment to see a neurologist so in the meantime I just keep going to my family doctor. I had a CT scan without contrast at the hospital, showed nothing, so they gave me IV of a muscle relaxant + anti-nauseant and sent me home.

Tried so far: tramacet (tramadol+tylenol), naproxen, advil, tylenol, tylenol + codeine+ caffeine and imitrex. Nothing has worked.

So my doc prescribed Amitriptyline (elavil). I started at 10mg for 7 days and I am now taking 20mg and it is day 10. Headache pain still here (some spasms throughout the day). The drowsiness and dry mouth side effect I can handle but it seems to have increased my heart rate and increased my anxiety (leading to a few panic attacks) as well.

My question is: has anyone tried Amitriptyline and it worked? how long does it take to work and at what dosage? I am just concerned that the anxiety is being caused by Amit. and I don't want to keep taking it if it does not work. Also if I keep taking it, and it does not work, then I will have to deal with the withdrawal symptoms. Please help, I need advise. :(
36 Responses
1577158 tn?1476511278
Hi there, I have taken amitriptyline but it was for sleep aid due to cluster headaches along with tizinadine.  The dosage is 25 MGM stopped taking due to trying to get pregnant.. It's a good sleep aid but as for headaches not so much.
Avatar universal
Thank you for your reply. Did you find another medication that was a better preventive for headaches? So far I'm not seeing much improvement, headache still there but I have only taking this for 11 days. I'm on 20mg now and I still only sleep about 6 hours a night....
Hello, I am 46 years old and have been suffering from headaches for most of my life. I have taken many forms of treatment from the ages of 5 and up. I have found some relief in acute medications; however, not much in prevention. Respectfully, look into a book called "Pain Free" by Pete Eqoscue. You can find it on Amazon for about $10 - $15. Learn about neck alignment and its relationship to chronic migraines. Then learn about mindfulness and biofeedback training. These practices can become your preventative. It won't always work but even to decrease the headaches 2x out of 10 wouldn't it be worth it? Finally, those things can also be used for a great deal of other issues in your life without the negative consequences of chemicals in your body. Good Luck!
4889363 tn?1360844688
I tried the amitriptyline for several months, it seemed to help me, in that it calmed my anxiety a bit and helped me sleep. However, it began to change my moods and made me groggy all the time. Amitriptyline and the like can help lessen your stress, sleep pattern triggers, and there are other meds and even natural remedies that can help with these as well. If your current med is really bothering you and your headaches are the same, I think you should tell your Dr and maybe he can give you another triptan, like Nortriptyline. This other triptan is milder and might be better to help soothe your nerves until you can see a specialist.

At this point, honing in on your triggers might be the first step to your getting some relief.
If you can answer yes to one or more of my following questions, you might be closer to the cause of your crippling pain:

Are you living/working in a high stress environment?
Do you hold your head crooked, like in a bad chair over a desk for long hours?
Do you sleep on a couch with the TV on? (even if for a few hours)
Do you eat lots of chocolate?
Are your mealtimes sometimes skipped, or different day by day?
Are your sleep patterns constantly changing?
Do you need coffee to get going through the day?
Do you eat fast food, canned food, food that comes in a box (like hamburger helper or rice dishes) more than twice a week?

Migraines are strange things, for the pain comes from triggers that (before your headaches really took off) might never have caused a thing. If no meds are helping, you might want to hunt down the cause and do your best to eliminate it (or lessen, as in the case of stress.)

I have had crippling migraines all of my life and meds only help when you become fully aware of your triggers. I can help you with what I've learned if you want to know more.
Avatar universal
Ive literally tried everything. My last straw was last time at the er they gave me a coctail of reglan benadryl and toradol. Reglan gave me severe panic attacks. Im currently taking lortab for them and it helps but i stress too easy and I dont want to be high every other day lol. Please inbox me about the amitriptyline and if it helped! Im pretty desperate
Avatar universal
An update: headache still ongoing- 3.5 weeks continuous
Thank you for your suggestions for looking into triggers. I have been keeping a headache journal trying to keep track of symptoms and what I eat but I have not found a trigger yet. I am light sensitive these days so I try to avoid being in too bright rooms or watching tv much.

I am still taking amitriptyline at 20mg, it has been a little over two weeks. My doctor insists that I stay on it for a couple of weeks longer to see if it is working. I have noticed that it has lessened the pain a bit, though I am still getting 1 or 2 migraines (?) a week. I have not had a headache free day yet. I wonder if this is the best I can expect from the meds, lessen the pain, or if I'll actually have a headache free day...

@lilseamonkey Have you tried a migraine preventative med yet? You mentioned you have tried everything. I'm new to these headaches/migraines but from researching online, I have found that there are a lot of meds used as migraine preventatives such as anti-depressants, beta-blockers, anti-seisure meds and calcium channel blockers. Amitriptyline is the first one I've tried, it seems to have lessen daily pain... but I am having anxiety and increased heart rate as a possible side effect. Different ppl respond differently to meds though, so maybe speak to your doctor about it?
1577158 tn?1476511278
To replace amitriptyline I take Benadryl to help me sleep and it works now.
Avatar universal
@Dolphinleiker It's good that you found a med that works for you. Unfortunately, I am not taking Ami for sleep but for the 24/7 headache that I have been having. From reading other people's experience with Ami, I thought it was going to help with sleep as well. Sleep is the only time when I don't feel my head hurting. :(

4.5 weeks since headaches began.... 3 weeks on Amitriptyline, headache still here. The pain feels different, a bit less severe and at times feels like a burning pain at the back of my head. I'm giving the Ami a couple more weeks to see if there's anymore improvement....
Make sure your doc has ruled out Chiari malformation.  Have you had an MRI done?  My daughter has the daily headache with intermittent migraines and was diagnosed with chiari malformation.  It is a cerebellar tonsil herniation.  MRI would show it.
Avatar universal
Just wanted to do a quick update, I was researching amitriptyline again and came across my own post LOL

Since my last post, I have gone up to 30mg of amitriptyline (since end of Feb.). I saw a neuro in March, who told me that I had a sinus infection (this was shown on my MRI) and told me to see an ENT instead. No follow-up appointment.

I went to see a second neuro at the end of May who told me I likely never had a sinus infection (wasted time taking antibiotics and Nasonex) and it was likely migraines aggravating my sinuses.

I was diagnosed with chronic daily headaches with chronic migraines. I was told to up the Ami to 40mg and max 50mg if no improvement. I see him again in three months.

I still have a fast heart rate, some anxiety and palpitations that I think is the amitriptyline. My migraines have been bad again, so I'm thinking its time to go up to 40mg. I'm just so scared of how it might affect the side effects that I mentioned.

Can anyone share their experience with amitriptyline, daily headaches or chronic migraines??
Avatar universal
Everyone has different effects from medication, so it doesn't matter whether others have had the same reaction.  You think that you are having the reactions.  Also, I don't see where you say whether the amitriptyline  has helped you or not.  But if you're still having the faster heart rate and anxiety, then I think that you should talk to your doctor about it.  Why don't you try another prophylactic med for your migraines?  There are a lot of them.    Good luck.
Avatar universal
Wanted to share my experience on migraine. I had this migraine from past 10 years. and its becoming severe day by day. I had amitriptyline 25 mg for 3 months and it completely got rid of headache. but when i stopped migraine triggered back and becoming worse day by day. Even now a days i have migraines 3 to 5 times a week and lasting for 6 hours. I consulted neuro and he suggested me to take divalproex sodium 250 mg for a month from today. So let me see if this medication can help me in getting rid of this migraine.

Meanwhile one thing in home i do for controlling headache is crushing the ginger and applying it on the forehead and back side of neck.
Avatar universal
You must have had some bad side effects, the reason why you stopped the amitriptyline which helped you so much..  I'm also assuming that you are not Trixx.  It's unusual that your doctor gave you an anticonvulsant medication, but yes they are used to prevent seizures. You must have already failed on some other classes of daily meds to prevent migraines.

And have never heard of the ginger.  I don't know how to crush it.  I would have to grate it.  Would that work?  It's worth a try for me.

Avatar universal
My Doctor has just prescribed Amitrip 10mg for cluster headaches. I had another bad attack in August which lasted for 11 days. I am trying the Ami as a profolatic, otherwise I am prescribed morphine when an attack occurs. There  seems to be no reason why I get them. All I know is when they come I cant sleep, cant work and cant cope.
Avatar universal
How are you doing now?  My headaches sound exactly like yours.  I wake up with them and they progressively get worse through out the day. Sometimes the pain is like a pressurized vice grip, sometimes it is a burning pain.  I have a history of Migraine but these are not Migraine.  My neurologist thinks they are rebound headaches from taking too much Advil and sudafed for my sinuses, which I also have trouble with.  I tried 10mg of Amiitriptyline for 4 weeks but asked to be taken off of it due to not seeing any improvement and gaining weight.  I was hungry all of the time.  He then put me on Topamax, which is not helping.  In fact, my headaches have gotten worse.  I have worked my way up to the maintence dose of 50mg twice a day within the past week and do not care for the side effects that I am experiencing (moodiness, dizziness, fogginess and inability to focus) but my phone calls to my neurologist do not get returned. (Time for a new doctor!). I have a consult with an ENT next week to get his opinion to see if my sinuses are playing a role in these headaches. I would love to know how you are doing now!
Avatar universal
I have been suffering from cluster headaches since September 5 and they have progressively gotten worse they come everyday about 8 times a day lasting only 30-50 minutes but absolutely excruciating. I recently went to the doctor and she prescribed me sumatriptan 5% nasal spray with one spray in the nasal side where the headaches are and with in 5 minutes they are gone..and oh my god it works I have taken up to 20 % solution and it keeps them gone all day the only problem is my insurance company will only pay for 6 individual sprays tubes a month. I have gone online and found the Canadian pharmacy where u don't need a prescription to buy the sumatriptan at 20%solution a 16 day pack which is 156$ but so very worth it. It keeps the headaches from coming. To all who have not tried I urge you to talk to your doctor because before it I attempted suicide twice because of the pain being so unbearable. I can say the only side effect I have gotten is an upset stomach and I will take that any day over the headaches.
Avatar universal
Our 8 yr old daughter came down with a virus/ flu like illness (possibly even Lyme) back in March /2013. She developed chronic 24/7 head pain at the onset of this illness that intensified at night. Nothing would touch it. We often slept in our clothes thinking we would be heading back to the ER for an IV of toradol and compazine (which only worked to put her out and pain returned when IV wore off). Long story short we have taken her to cincinatti children's hospital (#3 pediatric neuro hospital in US). They determined she was suffering from "new persistent daily headaches" which are often triggered by a virus or flu like illness. She had been having severe chronic head pain for 7 months!!

She was put on an experimental protocol developed by Dr Hershey there at Cincinnati in which she was to ramp up  amitriptyline very slowly over many weeks . She started at 5 mg and went up by 5 every 2 weeks until she reached the therapeutic level of 30 mg for her. We followed this to the letter for many weeks and became discouraged as we got to 15, then 20 and no response...but then, about 2 weeks into the 20 mg dose we noticed she would have periods throughout the day with no pain!! Then, several days later she went ALL day without head pain which was the first time in 7 months!! It was like a light switch! It took several months but we are SO grateful for her relief!  Apparently you must stay on the drug consistently at a "therapeutic" level for an extended period of time to achieve results. In our case she has now been headache free for about 6 weeks after reaching close to her therapeutic level. I hope this helps someone.  

Hi, I tried to email you! I am desperate in finding any information that can help us make decision. My daughter is 10 and has been out of school for 3 months now. Started with bad flu/virus and never bounced back. Developed bad headache that has yet to subside. Nausea and extreme fatigue as well. She's been on 10 mg of elavil (amitriptylin) for 6 weeks now with no improvement. I'm scared of increasing the dose?
How is your daughter doing now? Was she going to school all that time? How were her spirits? I'm concerned about the fact that she's taking one dose of Advil and one dose of Tylenol everyday for so long. Please feel free to get in touch! Thx so much
Avatar universal
Make sure you are taking the amitriptyline at the right time, best @ 1/2 hour before going to bed & most important is to get at least 8 hours of sleep. Not enough sleep while taking this med. will be the cause of your headaches. Increasing the dosage at the right rate is very important.& sounds to me that by now you should be @ 50ml. If you aren't taking it at bed time could very likely be the cause of the increased heart rate. I am talking from experience & need to take another med. for my chronic migraines.  
Avatar universal
I responded to you over the summer and the post does not seem to be up here. So, now, with a few months of Amitriptyline under my belt I'll report my progress.

My headaches: chronic (more than 15 days) now down to 7. I used to experience pain daily, even if not a full-blown migraine. Now, I have mostly pain free days except for the headache days.

Drugs I am on: Amitriptyline 30 mg, topomax 150 mg, back to back Lutera (bc pills) to halt my period (half pill in am and pm)  with a .1 vivelle dot patch 2x per week to even out estrogen, sertraline between 25 and 50 mg daily, Botox for migraines. Zomig 5 mg pill as abortive (which I often take after Zofran so it works). Zomig spray of I need something fast, or I've eaten (works best for me on empty stomach. I also take magnesium and butterbur each day.

What I have tried: nortriptyline, a beta blocker, more topomax, and anti convulsive. Relax, imatrex, sumitriptan, frova, dhe (migranol). IV treatments. Steroids to halt multi-day headaches.

Summary: the combo of amitriptyline and Botox for migraines has worked the best for me. Prior to that, stopping my period put the biggest dent in my migraine pain cycle. I suspect that my cortisol level was faced by confronting some demons I had been sweeping under the rug, thought I had accepted, but we're really putting my hand over the red button all the time. I do 't know about yours, but my body has a way of saying, "Um, yeah, this is not working for me."

All of this was run by a neuro at Mayo and the only thing he would change is as follows:

1. No real evidence that being on two preventatives works. So, staying on Topomax okay - but I could consider pulling off of that eventually.

2. Amitriptyline can go up to 60mg - if I need to up the ante.

3. I could get an injectable abortive drug (at that time Iw as getting a lot of IV treatments) - like DHE - if I need to up the ante.

That's it. So feel your pain. I've had to be very aggressive in finding a solution. Mine came on very fast and very strong.
Avatar universal
My now 13year old son has suffered from severe headache with no relief for about 18 months. Possibly following an infection (he suffered from Pandas as well - no longer). No explanation, no remedy. We will absolutely try this. Thank you som much for your detailed description.
Swedish mom
Avatar universal
i was on amitiptyline for 2 years then it stopped working and my headaches actually got worse. i have tried a zillion meds nothing worked but verapamil. i get the aura and stroke symptoms with my migraines. do you have a PFO? its a hole in your heart. the test for it is called a TEE. a lot of people who have migraines have this. closing it can actually help your headaches. did for me on top of verapamil.

http://www.pfodoctor.org/    - you may want to read about it.

hope you all feel better and get the relief i did. :)
Avatar universal
I am 35 years old female with diagnosed 4 years ago Cluster Headaches symptoms. My GP prescribed sumatriptan tablets and a spray to try whatever best worked for me. We started off with 50mg but 2 years ago I have asked for 100mg and if not too severe headache I would half the tablet and take only 50mg. My headaches were really bad with symptoms such as: waking up in pain in the middle of the night, pain in the back of my eye, pain in my neck, watering of the eye; a runny and bunged-up nose; constriction of the pupil in the eye; and absolute photofobia - I would refuse to have the curtains open until the pain was gone.
The headaches appeared out of the blue. Once a month or twice a month and would last between 24-72hours at the time. I kept a diet diary and tested myself for chocolate, wheat, milk & cheese intolerance. Staying away from chocolate does help a lot to lengthen the period between the attacks but the headaches do still occur. I have recently been to my GP to report that migraines occur with unusual regularity linked to my period: I have cluster-headache symptoms 2 or 3 days before my period, every month. I continue taking sumatriptan which always help - not the nasal spray (it never worked for me) but the tablet but I have now asked my GP to investigate further the change of the pattern - she is referring me to neurologist (awaiting appointment) and meantime she asked me to take amitriptyline 10mg every night 3 hours before bedtime. I am starting it tonight.

Also, I have 1 sister, 2 years younger than me. She started suffering from migraines when she turned 30, too. Sumatriptan had awful side effects on her such as feeling nausea, dizziness, tiredness and heart palpitation - she continues with cocadamol and ginger tea but her headaches last a lot longer than mine and she hasn't been able to find a medication that relieves her pain like sumatripan does in my case. The only time she was free of those migraines was the whole pregnancy.

We also wear kitten heels and flat shoes rather than high heels - wearing high heels for 3 or 4 consecutive days guaranteed a headache the next day.

Avatar universal
Hi all,
I am currently on amitrip. for migraines. I had daily headaches for several months. For several days in a row, I would also feel nausea, dizziness, and very weak. I tried extra strength Tylenol, Gravol, allergy meds, going to the chiro (to treat vertigo and to make sure it was not a neck problem) and the eye doctor. After seeing my doctor three times and having blood work done (all fine) he sent me to a neurologist. I saw one 4 years back and had an MRI which was fine, so I was then diagnosed with chronic headaches that were made worse by bad posture/stress.

Flash to now, I not only had the one-sided headaches again but the feeling of general unwellness was driving me crazy. My equilibrium felt totally off and I wondered if I had labrinthitis on top of my headaches.
My neurologist did his tests and after hearing me out (how I did not notice a pattern in the headaches, that some days were better than others, could not find a trigger, etc). diagnosed me with migraines. He reminded me that they don't always come with a headache, as I argued that sometimes the symtoms were worse than the headache pain. He told me to lay off on the painkillers and to start with 10mg of amit, then 20mg, then 30mg.

The first week I slept like a rock which was great; my sleep had been terrible for months as the headaches would burn in bed, and I would get terrible anxiety and feel sick. Second week I also slept well, but noticed the tiredness right away. I have now almost been on it a month and my headaches are back. I still feel dizzy as well. I was hoping with time the meds would kick in and help with the symptoms, but now I dont know what is me and what is the meds, since their side effects can be dizziness, fast heart rate, fatigue, etc.
I see the neurologist again in a month and a half, likely to see how I am doing with the meds. I am going to give it another week or two but if I feel the same I may ask to be given something that actually deals with the pain and does not cause dizziness since I already feel off. Fatigue is also hard to deal with, even after getting a long night's sleep.
Avatar universal
Thank you for sharing this experience, it is very helpful.  
Avatar universal
Hi again,
It's been a month since I last posted so I have been on amitrip. for almost 7 weeks. I started out feeling exhausted on only the 10 mg and even worse by the time I got to 30 mg. I noticed at the four week point that the headaches were reduced and I was not having migraines. Last week, so week 6, headaches started again. I still have them this week everyday; a stabbing pain on one side of my head. No migraines however for a couple of weeks. Still feel tired but not as badly; definitely have dry mouth all of the time. I have been sleeping ever since I have been taking it and I was not before. My skin is also much more sensitive to the sun. My neurologist advised me to not take pain killers since I will just get used to them and get rebounds. Pre-medication I was taking 4-6 extra strength Tylenol a day. Since the medication, I have taken 1 Advil sporadically when I cannot work through the headache. For the past 2 months I have kept a headache diary and have cut out alcohol, caffeine, fatty foods and have been drinking much more water. I also started taking magnesium.
I see the neurologist next week for a check-up.
Avatar universal
If the Amitiptyline does not work, then try other daily preventative migraine medications.  A variety of those meds did not work for me, except Petadolex that can be purchased online DID help me.  But with exceptionally severe, 24/7 migraines caused by a major stroke, I have needed far more.  

And to the rest of you, you can get Botox injections if you have not been helped by the daily meds and have migraines at least 15 days a month.  The Botox has helped me the most.  Also I get nerve block and trigger point injections which also help me a lot.  Plus I have physical therapy exercises which help to loosen up my tight muscles in my neck and shoulders which contribute to the migraines.

So there is a lot of help out there.  You all take care.

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