Nortriptyline for Headaches

Nortriptyline hydrochloride (Pamelor®) is a prescription medication approved to treat depression. However, on occasion, healthcare providers may prescribe nortriptyline for other, unapproved uses (or "off-label" uses). One of these uses involves preventing migraine headaches. Nortriptyline can be used on a daily basis to prevent migraine headaches -- however, this medication is not effective at treating a migraine once it starts.
To avoid long-term side effects of preventive medications, headache specialists recommend that people reduce the dosage of these drugs and then stop taking them as soon as possible. However, it is important to note that it may take two to three months before you notice a decrease in the frequency or severity of attacks, and treatment may be required for 6 to 12 months or longer.
Although it is not exactly clear as to how this drug works for preventing migraine headaches, it is believed that nortriptyline affects certain chemicals in the brain (including serotonin and norepinephrine).
(Click What Is Nortriptyline Used For? and Migraine Medications for a more in-depth look at using nortriptyline for migraine prevention. These articles also discuss nortriptyline's use in children and outline other medications commonly used for migraine treatment.)
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