Advised by GP to try amitryptline for persistent headaches

[maimeo]

Been attending GP over last four months about persistent headaches, lasting two/three days at a time. Left sided top of head. Unlike my rare migraines which always begin with an aura - different pain and as I say occasional. Thankfully CT brain and MRI neck have ruled out anything serious. Have tried diet changes and extra water too. She now says next step is prophylactic amitryptline every day. Have been referred to Headache Clinic but public waiting list nearly a year. I'm extremely nervous of taking amit for a number of reasons - the sleepiness the morning after, possible heart implications, weight gain when I'm working hard to lose weight at present, etc. AIBU to keep putting off starting it despite headaches since Friday rendering me unable to concentrate on anything. Would love to hear other posters' experiences

Yes they are not painkillers and where specifically designed to work on migraine (the first drug in fact to do so). They effect the serition 5HT inhibitors in the brain hand have been around since the 1990's. They are abortive medication only though not preventative.

There are a new class of CGRP'S (also effect serition) available which are preventative medication but you can only get them through neurologist and not all NHS trusts currently have funding for them as they are expensive medication. They actually aren't any more effective then most currently avaible preventative medication which is why you have to have tried everything else first before they will let you try them.

I've been taking it for migraines for about 2yrs. I started on a high dose of 25mg which I increased over time to 75mg.
It took a few weeks to find the best time to take them in the evening as they did knock me out & make it hard to wake but that subsided & now don't cause any problems in the morning.

I do find if I forget to take them I have a disturbed sleep, so they really do help me sleep soundly (but not to the extent I wouldn't wake in the night to noises etc).

They've not prevented migraine but reduced the intensity so often over the counter pain relief is enough to keep on with my day.

The only side effect I have is a dry mouth in the morning - which is preferable to a migraine. Chewing gum (sugar free) helps this.

At 10mg it's definitely worth a go.

And having a night out / drink doesn't make a difference to me.

I take Vydura (rimgepant) as a preventative and it costs £310 per month on a private prescription with a private consultation to review every three months.

In my Trust it is only approved as an acute medication for episodic migraine (up to 8 tablets per month). So as a chronic migraineur who needs it as a prophylactic I have no chance.

Can’t really afford it but it’s changed my life. It’s the only thing that’s stopped the pain in 30 years. I may even be able to return to a proper career.

Forgot to say I’ve tried and failed five different tripten across three delivery systems. They work 30% of the time at most.

Thank you all for taking the trouble to reply with your experiences. I decided to give amitryptline a go and took my first one at 8pm as advised. Heading to bed now and looking forward to a good nights sleep!!

Sorry. Know this is an old thread - but searching through relevent threads as just about to start on 10mg for same reasons and wondering how you got on?

@BabaYagasHouse Sorry, only seeing this now on 9/2/25. I presume you started the amitryptline and I wonder how you're getting on? My experience was that I only lasted a week on it as my headache just got worst and constant for a week. Saw different GP in same practice who told me to stop. In hindsight I wish I'd persevered longer, as amit can take a month or two to be really effective. In the meantime I've seen a GP Headache Specialist who offered me steroid injections in back of head, as he reckoned it was Occipital Neuralgia triggered from the neck. I went ahead with these and had blissful relief for exactly a month! He was not keen on repeating these injections so I was back to square one.

My latest try is weekly acupuncture and osteopathic massage. I'm afraid to commit to say this is helping, but I do think my headaches are of shorter duration. Maybe up to 36 hours rather than at least 72.......... fingers crossed!

@BabaYagasHouse How are you doing?

My husband went on amitrip for headaches at the front of his head, as did my son for Neuralgia.

It helped both.
Have you tried putting your feet in the hotest basin of water you can stand?
It is good for headaches.

Atlantic salt in water is good for hydration too.

Thanks so much for responding @maimeo !

Sorry it's not worked for you.
I have heard acupuncture can be helpful, so fingers crossed for you.

Been on amitryptiline for about 3 weeks now, so maybe too early to tell. Sleeping like a log though!

I'm prescribed for vestibular migraine, and attacks had been coming about every 2-3 weeks. They are very extreme! So it'll be interesting to see if it's kept at bay. May have to try going up in dosage if not as the next step.

Not experienced any of the nasty side affects other than a bit drowsy in the mornings so far.

I'm thinking with poor sleep being a trigger, just the improved sleep might help to some degree.

My friend who has (non-vestibular) migraines reported similar outcome to you on amitryptiline.
A blood pressure med (not propanalol) has helped hers.

I was in panic mode when I posted after reading on various threads of so many bad reactions. Interesting how our bodies respond so differently to different meds.
It's seems to all be so experimental/trial and error with migraines!