Does anyone know why Amytriptalin is prescribed for IBS - and not SSRI's (when 95% of the body's serotonin is in the gut)? Who's had SSRI's?

[AfricanSheila]

[Morwenna]

umm is it to relax the intestine spams i wonder sorry not very helpful

[Morwenna]

did find this in a research mag Mechanism of Action

According to Owyang, tricyclic antidepressants such as amitriptyline appear to combat IBS in two ways: First, they decrease the rate of muscle contractions in the small and large intestines, slowing whole-gut transit, which moves too fast in people with diarrhea-predominant IBS. Second, they appear to quell overactive sensory nerve endings in the bowel, much as they do for overactive nerve endings in the brain in the case of people who suffer from depression.

dont think i am allowed to link you but that is what it says

[Morwenna]

Two types of antidepressants are used to treat IBS – tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).

TCAs are usually recommended when antispasmodic medicines have not been able to control the symptoms of pain and cramping. They work by relaxing the muscles in your digestive system.

However, TCAs will only provide relief after three to four weeks, as your body starts to get used to the medication. They should be taken consistently.

Possible side effects of TCAs include:

dry mouth

constipation

blurred vision

drowsiness

These side effects should improve within a few days of starting the medication. Tell your GP if the side effects become a problem – they may prescribe another type of antidepressant.

Amitriptyline is the most widely used TCA.

Selective serotonin reuptake inhibitors (SSRIs) are an alternative antidepressant. Examples of SSRIs that are used to treat IBS include:

citalopram

fluoxetine

paroxetine

Common side effects of SSRIs include blurred vision, diarrhoea or constipation and dizziness

[MarkBrennan]

I tried SRRIs for a few months (10mg of Citalopram a day) but it didn't help me. I have never been given Amytriptalin - but then mine is predominantly C

Just to add that when I was looking into it, originally, a few websites said that Escitalopram is a newer SRRI and has less side effects (such as upset stomach!)than Citalopram but most doctors automatically prescribe the latter due to cost. People really need to insist on being given Escitalopram (ie Cipralex)

[Raas21 in reply to MarkBrennan]

Hi Mark. That sounds like good advice. Citalapam for anxiety never helped me. I took up to 30 mgs at one stage for over three years.

[Raas21]

Hi there. I've been considering asking my GP for either one. I was on Citalapam last year for anxiety and can't say I noticed it helped. The Amatriptalyn seems to be recommended but it is an old fashioned anti depressant I've decided to take neither !!

[flanimals123]

I don't know if you have ever thought about natural foods that raise seratonin levels. I have read a lot of research in America on the links between IBS and seratonin levels. If you google seratonin foods it will give you lists of excellent sources to raise levels. Such as brown rice green leaves etc hope this is helpful .

[skrillex85]

I have been on citalopram, sertraline and now I am on mirtazipine for bipolar disorder. They don't really have any effect on my symptoms.

[Ksheridan]

I am on amitriptyline- 20mg on an evening (you can see my experiences at mylifewithibs.com), but I haven't noticed any significant difference solely as a result of that. I will be weaning myself off this shortly, as I've moved to a FODMAP diet, and dicycloverine hydrochloride which is great for pain management! As a rule of thumb, I tend to give 6 weeks to see if a medication is helping me before reviewing it with a Doctor and trying something else- as is recommended by Doctors. As other people have mentioned there are different medications you can try, so always go back to the Doctor after a trial period, to see if there is something else more suitable or different dosage etc.

[PatV in reply to Ksheridan]

I haven't seen a nutritionist yet and I have IBS-C but the list of low FODMOPS foods is much more varied than I see on your food diary. Thanks for keeping it by the way. Takes great discipline. I don't see berries, oatmeal, spinach, etc. Maybe you have a reason for this (?) Good luck. I'm going through a hard time too. My mom is in a hospice and far away and I'm too ill to be with her. Stress exacerbates all symptoms. Hang in there!

[PatV in reply to Ksheridan]

p.s. in Thailand did you eat rice noodles? or green papaya salad?

[Ksheridan]

Hi, thanks for replying. I do eat spinach, but I introduced it further into diet. Also with the Oats, I started to realise that I could not tolerate these at all in large quantities, ie daily, though I will be introducing them again at some point.

I appreciate my diet overall though was quite bland and there are a few reasons for this. I'm travelling round the world at the minute and started FODMAP at almost the same time, so I was/ am eating on the go a lot and eating out a lot, which makes it tricky to eat foods which are 'ok', so for me it was easier to stick to relatively plain food.

Also for the first few weeks I had no access to a kitchen which meant eating out or making foods which required no cooking, so my options were quite limited. But the main issue was that before this trial I couldn't stomach anything, and no matter what I ate, I was very ill every day, even more so with 'healthy' foods such as salads, fruit and nuts. The only really safe 'healthy' foods I could eat were almonds, spinach, bananas, blueberries and orange juices, so I just decided to strip all the foods which caused me issues, and start very bland and build my diet up. Now the 6 weeks have passed I should be able to start introducing a lot more foods, though I am still travelling in Australia and we have very limited access to the kitchen, though we will be moving again soon where I can cook and prepare all the food I want. I cant wait! I really hope I can start experimenting with food again but I don't want to get too excited, as we all know too well, that IBS has this awful habit of randomly flaring up again.

In Thailand, I mainly ate rice! It wasn't good at all for my body or FODMAP eating in Bangkok. Next time I visit Asia, I shall be doing a lot more research into where to eat or at least staying somewhere where I can prepare my own food.

Similar to you I also don't have a nutritionist but I am going to try and find a reasonably priced one over here whilst I am travelling, which will help give me more variety hopefully.

I'm sorry to hear about your situation with your mum. I hope you feel better soon so you are strong enough to visit. I wish you all the best.

[bellamia in reply to Ksheridan]

dont know why amytripteline helps ibs d.i was put on 75mg dose for depression,and as im on pregablin too a lot of anx and dep tablets dont mix very well .i have had ibs since i was 17 and im 55 now all these years i have suffered pain and some days i would go to loo 20 times a aday,which left me exhausted and sore...i had to miss hospital appointment,weddings parties,and on holiday at least one bad day of i lost too,..but since the dr put me on amytrip 25mg,didnt do a thing,then he upped the dose to 75mg,and i have never looked back!it works very well for me and after suffering from ibs d for all those years,feel well now,incidentally,had endoscopy,colonoscopy,sigmoidoscopy,it revealed a hiatus hernia and diverticular dis,but knew that already after a barium meal test .im so sorry i cant answer how amytript works but from 1 sufferer,it has worked very well.

[AfricanSheila in reply to bellamia]

Thank you - it helps to get some feedback.

[AfricanSheila in reply to AfricanSheila]

Thanks to ALL for your responses.