Elavil helpful for migraines?

December 14, 2015 2:37 PM

I get migraines that are interfering w/ my day-to-day functioning (first grade teacher--enough said). While they are not the kind where I need to be in a dark silent room, they are extremely persistent and only respond to the triptans (to which they respond beautifully). However, the triptans are no good when you have to take them several times a week. I was on Topamax and thought it was working at first, but then realized it totally was not working at all...

I am on Celexa (20 mg), and my dr. just changed my preventative from the Topamax to Elavil (10 mg a night, but I can increase up to 50 mg if I need to. I already feel a bit zombie-ish, but I know this will wear off. Has anyone had experience with Elavil actually working for migraines? Especially for those of you who have tried Topamax and it didn't work? Thanks much!

posted by bookworm4125 to Health & Fitness (15 answers total)

I was on Elavil/amitriptyline for a few months for my migraines. I slept so much, and when I wasn't sleeping, I was eating. So I stopped it. :)

I was on Topamax for years, and it worked until I developed a giant kidney stone.

Now I'm on depakote, and it's going quite well. I'm down to one or two a month versus several a week.

Good luck!
posted by heathrowga at 2:49 PM on December 14, 2015

There're trials going on right now for the new monoclonal antibody therapy; if you qualify and one's being held near you, participation may be something to consider. I would totally do it but I have too frequent migraines for the current US studies.

Otherwise, a combination of Botox and generic Depakote are what's managing mine.
posted by vegartanipla at 3:10 PM on December 14, 2015

I took nortriptyline (which I know is not quite the same thing but is quite close and I believe is dosed similarly) and when I hit 30mg/day, my migraines were pretty much gone. I went from a max of several a week/average of 2-3 days a week but all the same migraine (to my way of thinking) to none. No menstrual ones. No sulfite-induced ones. No neck-pain-triggered ones. It was great.

Except. I couldn't finish sentences, and I was having trouble driving (or, well, I was driving safely, but it was really hard and scary, because I would think I saw something moving in my peripheral vision that I should avoid, like a car turning into me, and it would turn out to be the reflection of a tree on the side of the road in my side mirror). It wasn't grogginess, and it wasn't affected by what time I took it (and the brain fog didn't vary throughout the day). It also wasn't an adjustment period - I was on it for months. Neither my neurologist nor my fibro specialist had ever heard of anyone having that specific weird reaction, but they both agreed I wasn't crazy and should get off it and on something else. Now I take gabapentin, which isn't quite as good, but doesn't fry my brain.

I don't say this to worry you - just something to watch out for, and it went away completely, no lingering effects, once I got it out of my system - and it DID work fantastically on the migraines. So here's hoping you get the benefit without the side effects.
posted by dust.wind.dude at 3:18 PM on December 14, 2015

My neurologist, who is a headache specialist, says it's pretty much trial-and-error what meds will work for individuals. He also says that people who are prone to headaches tend, in his experience, to be more sensitive to side effects than most people.

I was on Elavil, and it helped but I found the side effects unbearable.

The list of meds that didn't help me is very long, and includes things like blood pressure medications, anti-depressants (Celexa helps a lot of people, apparently), and a drug from the 70s whose name I can't remember that was developed as an anti-depressant but didn't work for that, but turns out to help some minority of people with headaches.

I say this not to be discouraging, but to say that finding a good preventive and a good rescue med can be a long, hard process. Like dust.wind.dude, I hope the zombification wears off and Elavil works great for you. But I also want to encourage you to hang in there if the Elavil isn't your drug.
posted by not that girl at 3:36 PM on December 14, 2015

My sister managed some very bad migraines that corresponded with a particularly bad year of grad school with Elavil.
posted by jessamyn at 3:36 PM on December 14, 2015

I was on Elavil to prevent migraines for a couple of years. It worked fabulously to prevent the migraines. Unfortunately, it made me sleepy all morning, and kept me from caring about things I cared deeply about, so I stopped taking it.
posted by umbú at 4:01 PM on December 14, 2015

I take 10mg of Elavil every night, and have for the last year. I'm not sure it reduces the frequency of my migraines - my best friend often teases that I always have one - but it definitely reduces the severity of my migraines. Since starting Elavil I can knock out a migraine with a hefty dose of acetaminophen and ibuprofen, rather than the same plus hours in a dark room with a cool, wet cloth over my eyes. (I don't tolerate any rescue prescriptions well.)

I don't have any side effects, at all.

When I was in high school I took 25mg of Elavil at bedtime, also for migraines. It really wiped me out - I would have a sleep hangover the next morning - and they made me Hungry (and consequently a little pudgy). So I strongly suggest sticking with the very lowest dose possible.
posted by schroedingersgirl at 4:17 PM on December 14, 2015

Topamax works for me, but I have to take it at night because of the zombie brain effect. The dosing time can be staggered for a lot of the preventives - you can take it in the early evening and do light activities, then sleep, and wake up with a relatively clear brain for most of the day.

It's definitely trial and error. I had feverfew trialled before topamax, and it didn't make a dent in my migraines. My neurologist had me do about two months before making a decision on each medication.

If the side effects are too much after two weeks, you should discontinue because those should settle down and you still have other medications to trial after topamax and elavil. Talk to your doctor about what options you have - there are at least 5-6 preventives I had queued up, I was just lucky and topamax was the next one that worked for me.

And it can be just about reducing the severity. I still get migraines 4-5 times a week, but I can manage them with painkillers and function, not have to retreat to a dark room. Living Well With Migraines was super helpful in explaining meds and strategies in coping with migraines for me.
posted by dorothyisunderwood at 5:04 PM on December 14, 2015

I'm on 20 mg of Elavil for sleep and unfortunately it hasn't done jack for my migraines.
posted by sorrygottago at 5:31 PM on December 14, 2015

Topamax totally fucked me up.

I've been on Elavil, but right now, I'm on Verapamil and it works pretty well.

I am also a teacher (6th grade) so I understand. Verapamil is amazing and especially for the first six weeks, it was heaven. Now, I tend to get clusters of migraines around seasonal allergies. But no more soul-killing migraines for no good reason.

Good luck. It's a tough road.
posted by guster4lovers at 6:13 PM on December 14, 2015

Topamax was great for me. When i could no longer afford it we tried elavil but it made me SUPER dizzy and gave me the worst dry mouth that even lozenges and gum and dry mouth wash could help. And it didnt help my migraines
posted by misanthropicsarah at 7:27 PM on December 14, 2015

I started taking a daily multivitamin and it cured 90% of my migraines.
posted by aniola at 7:49 PM on December 14, 2015

Honestly there's no info we can give you on the internet. Having tried a bunch of these and interviewed many doctors about them, my conclusion is that you just have to try some until you find what works for your particular brain/body chemistry. Unfortunately this stuff is at the messy boundary of science.
posted by hyperion at 7:55 PM on December 14, 2015

I have been on elavil for a few months and then had a relapse so now I'm on both elavil and Inderal (propranolol). Can you try taking adding topomax to the elavil?

I saw pretty much zero impact from taking just the elavil, but it is helping a lot to take both drugs.

Agree with every one else that you have to find the right cocktail for your specific chemistry. There are lots of drugs to try, so gentle reminder to follow up with your doctor soon if you think you still need more help.
posted by skrozidile at 5:56 AM on December 15, 2015

Thanks everyone. I am experiencing what most people seem to--EXTREME sleepiness and wanting to put anything that does not move in my mouth! I got one headache yesterday BUT was able to knock it out w/ Tylenol, and then, a few hours later when it came back, Aleve. This NEVER happens. I am going to stick with it for a little while if I can handle the sleepiness all the time!
posted by bookworm4125 at 10:15 AM on December 17, 2015