Hi Buffy,

It can take a week or sometimes longer to acclimate to a new med. It can also take some time to get relief with it.

I take 10 mg of nortriptyline since it is the lowest dose. My side effects are pretty negligible. At 25 mg I was unbearably dizzy and somewhat foggy feeling. Not good for driving! I weigh 115 lbs for comparison.

I don't know that a physician or pharmacist would agree with opening the capsules and dumping half out for a week to try titrating her dose but I did this to see if I could discontinue (I couldn't). Since this is not a time release medication opening the capsule doesn't present any problems other than not having the dose down to the microgram to start.

Nortriptyline does give nerve pain relief and is a med considered safe in the pediatric population of she can tolerate it.