Hi, I am a 46 year old female suffering from migraines for over 20 years. I have tried everything with not much success (Botox, nerve blocks, chiropractor, beta blockers, calcium channel blockers,etc. there were also meds that I couldn t tolerate like Topomax, Zonisamide, and others). I have had a total hysterectomy and migraines have increased along with panic attacks. My neuro wants to try Vivactil...I would like to get a second opinion. My blood pressure sometimes gets around 135-140/90. We have been unable to determine if it is because I have headache pain all the time and/or because I have a lot of stress and anxiety. I have read that Vivactil can cause high blood pressure and low blood pressure...that is sedating and causes excitability so I don t know what to expect. I just don t want to have a stroke. I am trying to eat healthy and would like to start exercising but fear the med will make me have a heart attack or stroke. At the same time I am tired of suffering and loosing my life to migraines and pain.