AD's and IBS

[iOwlface]

Hi everyone,

I'm sure you've all heard about being or have been prescribed some anti-depressants for your IBS.

I had a bad flare-up of symptoms about 8 months ago after I'd increased my initial 50mg dose of Sertraline to 100mg. I finished up with serotonin syndrome after taking the higher dose for 3 weeks which was very scary. Since then my guts have never been the same. The mebeverine helps but I still get the odd flare when I'm anxious.

I did however find an article that states that SSRI's are better for IBS-C as they tend to make you a little loose..

Further down it states that SNRI's are better for IBS-D predominant sufferers, so I'm wondering if anyone has been prescribed Duloxetine or another SNRI and what your experiences have been?

I originally wanted to stop my AD's all together, but I'm currently on 25mg of Sertraline and old habits are starting to form again, so I'm pretty sure I need some form of medication to keep my anxieties at bay.

IBS anxiety sucks!

Anywho, thanks for reading

[Hetchins1946]

My IBS-d is very much associated with stress. There are no dietary factors that I've been able to find. My GP eventually prescribed Sertraline because of my increasing panic attacks. This has pretty much cleared up the IBS symptoms I was experiencing.

I've been taking Sertraline for about 2 months and have gradually increased the dose to 100mg (with some horrible side effects on the way).

It seems like early days to make firm conclusions, but so far, so good.

[StrawberrySmootie]

Sertraline was found to be the one with the greatest diarrhoea side effect.

I've been on loads of antidepressants for anxiety, but hoping for that constipation side effect too. The only one which had any effect in firming up poop was Mirtazapine which the GP can prescribe. Also good was Mirtazapine and Venlafaxine combo (california Rocket Fuel) but I got insomnia and nasty acid reflux daily.

TCAs are supposed to be the best, but you might need referred to a psychiatrist to get them. Docs do not like giving you them and always push the SSRIs.

I've tried Amitriptyline (no effect), Clomipramine (worsened), Nortriptyline (no effect)

I can't remember every drug I've had but certainly, Citalopram and Sertraline from the SSRIs were the worst. It was porridge poop everyday.

Serotonin should speed up the bowel and norepinephrine should slow it down in theory. Mirtazapine which is practically an antihistamine slows the bowel too. You'll have greater success with drugs lower in Serotonin percentages (again in theory)

[xjrs]

I understand that antidepressants are normally prescribed in low doses for IBS pain. Some drugs may have a constipating side effect that may be useful in IBS-D cases. The first go to drug for this is low dose amitriptyline - this has a constipating effect. You are right SSRIs tend to cause looser stools. SNRIs tend to have lower side effects than TCAs (amitriptyline). Looking at the SNRI drug list I have, they do seem to be more constipating.

I was initially prescribed amitriptyline, but couldn't tolerate this due to getting severe heart palpitations 18 hours of just taking 1 pill. I didn't want to touch the SNRIs as an alternative after that since they work on similar receptors and I am obviously sensitive to these kinds of drugs.

Is your anxiety caused by your IBS symptoms? If so, have you tried Alflorex probiotic, which has been scientifically studied for IBS, since many people's IBS is related to a gut bacterial imbalance? IBS can make you restrict your diet to control symptoms, but this reduces feed for the microbiome, making your gut bacteria less diverse and allowing the bad bugs to take even more of a hold. Alflorex helps to kick the bad bugs into touch, reducing symptoms, allowing you to eat a greater variety of foods. This greater variety improves the microbiome and in theory helps to improve IBS symptoms i.e. it helps you to get out of the bad bug, getting symptoms, eating less, even more bad bugs loop.

[trace55]

Hi yes i think its nerves as well i have the lowest does of citilapram 1 aday and mebeverine 2 times a day most days ok with that .

[xjrs]

It's a shame you needed to stand up for yourself like that. No patient is 'difficult' - it's just they have concerns that they need to express and doctors need to handle this. Fortunately my doctor immediately put amitriptyline on my 'allergic reaction' list, so I would never be administered it in future. We also had a reasonable discussion about SNRIs and agreed its best that I don't try them. I thought doctors are now meant to be trained to empower their patients, helping them make their own decisions.

[eyeofthetiger123]

Hey, there are alternatives. Thiamine (B1) in large doses is therapeutic for anxiety, but also there is passionflower and rhodiola amongst things to help manage anxiety. I gave my boyfriend B1 as he used to abuse alcohol and now he is a changed person. We found this solution after he had sertraline followed by mirtazapine both which caused personality traits that were horrible for him and his family. Feel free to message me if you would like some herbal advice xxx.

[Pte82 in reply to eyeofthetiger123]

eyeofthetiger123, glad you brought B1up. Often overlooked is the magnesium needed to activate it may also be deficient. You'll appreciate Hiding in plain sight - thiamine deficiency.

[MDipp in reply to eyeofthetiger123]

What is Thiamine (B1)? What does it do? What brand do you take?

[eyeofthetiger123 in reply to MDipp]

Hey, B1 is a vitamin so like all vitamins it is used for by cells to grow and function. However, it is also only produced in small quantities by the liver. To this end, if your liver function has been compromised or is not as it should for reasons such as diabetes or alcohol abuse more thiamine is needed. Also, therapeutically, it has been used as an anti-depressant, but without the side effects that some anti-depressants have.