Positives

• On the Drugs.com migraine-prevention page, patients describe nortriptyline as a “miracle” medication, including one reviewer who took Pamelor for nearly 4 years after constant migraines following a brain aneurysm procedure and another on 10mg at night who was pain-free after a couple of days and felt “like a new person” Drugs.com.
• For nerve pain, one Drugs.com reviewer with small fiber neuropathy reported their calf pain began to dissipate after a few weeks on 100mg/day, and another patient who started it for sleep problems realized it also reduced nerve pain in the back and neck; reviewers commonly mention sleeping “like a baby” on 10mg at bedtime Drugs.com.

Negatives

• Patients commonly report anticholinergic side effects: dry mouth, severe constipation, drowsiness, dizziness, blurred vision, slight weight gain, and difficulty fully emptying the bladder — reasons many patients eventually discontinue StatPearls.
  
  

Hurdles & Side Effects

• Patients commonly start nortriptyline at 10-25 mg at bedtime and work up over 4-6 weeks; many describe needing a baseline EKG before starting because higher doses can cause cardiac arrhythmias, and the slow taper-up is what most patients say keeps the side effects tolerable BrainVoyage.