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How do you know when it's okay to wean amitriptyline to the next level?

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You don't have to wean off, but if that's what you prefer.. I'd go down the same way you went up, and if you have withdrawal symptoms (which you likely won't) - you wait for them to subside before stepping down again.  That's the general way to wean off something.  I don't see you actually saying that you're doing this on your own without your pdoc knowing; but, if that's the case, you do need to call them and let them know.

I believe it is your right to choose to stop a med - but you need to let your doctor know what you're doing and why.

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Thank you Cetkat. Finally, the answer I'm looking for. My doc has been suggesting I get off this med for awhile. I'm the one that keeps insisting it helps my headaches but that's all it does. I finally see where it has increased my anxiety, insomnia and blood pressure.  Instead of stopping abruptly. I thought weaning is better.

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You're welcome. I'm glad I could help. :)

Cold turkey vs weaning is really a personal preference (unless it's an anti-seizure med; that always needs weaning, for obvious reasons).  Do whatever works best for you.  Those pills can be cut in half too, FYI.  So that gives you some options.

Have you ever been on a beta-blocker like Nadolol?  Taking that in the morning can help prevent migraines (proven treatment), and IMO, headaches too.  It could be something to try.

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I know others said this but to repeat what my doctor said to me "The only thing that REALLY makes me mad are patients that just stop taking meds without telling me." 

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