Has anyone tried Nortriptyline?

[rustydog]

After 23 years of IBS with the last 4 years being virtually daily I am at the end of my rope. I have tried absolutely everything recommended for this awful complaint and nothing has helped. I really need to do something as I live in constant fear I have something serious (despite a clear colonoscopy and gastroscope in 2019), I only eat very limited low fodmap foods, live in constant fear of an accident and in general have no life anymore.

I am IBS mixed which is so unpredictable, I can have days where I struggle to go and just as quick flip to diarrhoea. My digestive system is never settled from burping/acid/indigestion to excessive tummy gurgling and evening bloating to the dreaded D or C.

One thing that I haven’t tried are antidepressants. I have been prescribed Citalopram and Sertraline in the past but didn’t take them as I’ve read they can cause more diarrhoea issues and in all honesty if I had to choose one or the other I would rather have constipation as diarrhoea sets off my anxiety. I have read that the older TCA’s as in Amitriptyline or Nortriptyline are good for the gut/brain issues and are slightly more constipating. I have heard that Nortriptyline is better tolerated?

Has anyone had any success with either of these meds? I am loathe to take any meds but fear that I am never going to free myself from the cycle of symptoms/anxiety over symptoms and more symptoms...........

[FRreedman]

I suffer from IBS and IBD among many other illnesses and syndromes. I take Nortriptyline along with many other medications and can say that I have not noticed any difference with regard to my IBS. I have been on Nortriptyline for about 3 years.

[CGilly]

I took sertraline for around 3 months without side effects- although I have since discovered it is recommended you take for at least 6 months. I was only on a low 50mg dose but it did help me. I took citilopram prior to this but it didn’t suit me at all and soon ceased taking it.

[Liz1234ty]

Hi Rustydog, both Amitriptyline or Nortriptyline are clinically proven to be effective in properly controlled trials. Clearly they won't work for everyone but given that you are a long term suffer and have tried other things I would say discuss with your GP/gastro to ensure there are no contraindications for your personal health history and if not give it a go! You will need to try for several months and slowly taper the dose upwards if not effective at a lower dose. I tried Amitriptyline for roughly 9-12 months but it did not work for me and made me really sleepy so I slowly tapered off it. This was a hard process as these drugs are addictive but given the misery of IBS it is worth trying.

I am now on Mirtazapine and for me this worked from week one. I have taken it for about 9 months now and it is much more effective than anything else I have tried but it is certainly not a cure and I still have bad days and weeks, but less frequently and less severely. This is clinically proven (over placebo) for IBS-D, nausea, pain and anxiety NOT IBS-C and NOT bloating. I have no side effects from it except increased appetite so particularly good if you are underweight otherwise care required!