Amitriptyline - ATLANTIS clinical trial

[xjrs]

Can anyone explain to me why money has been spent on a clinical trial for amitriptyline in relation to IBS, when this has been prescribed for IBS and specifically IBS pain for years already?:

theibsnetwork.org/blog/irri...

When investigating IBS research I have found that there are so many repeated scientific studies regarding IBS across globe, when money is much better spent on current unknowns, such as how food intolerances occur and how to reverse the mechanisms that causes them, which is what blights most IBS sufferers on a daily basis. Very frustrating.

[Pedrof1976]

Hi, reading the link, I think it's that amitriptyline isn't licensed 1st line and the evidence is all in specialist settings not in the community. In order to change the licensing they have to prove it is better than the 1st line drug recommended. They're also looking at whether the benefits are on mood or pain, knowing this influences the licensing process with NICE as they guidance must be clear how it will be used. Giving it 1st line would be prescribing outside the licence within the UK

[Andann in reply to Pedrof1976]

I dont know how many studies have been done but I think the medics like to repeat them to prove that something works consistently.

[xjrs in reply to Pedrof1976]

Thanks for your reply. I had the impression that amitriptyline was more widely prescribed. I believe that it has been used second line for some years. For instance, from memory, it was first suggested to me more than 15 years ago. I just think that in terms of priority of allocation of funding, novel and brand new treatments are far more pressing. Additionally, my GP once mentioned that there are large numbers of the population who can't tolerate nerve pain agents like amitriptyline.

[edwangy]

and it doesn't work

[MKG50 in reply to edwangy]

It does for me. I have IBS-c and have always taken one Movicol a day to help with that. I started on Nortriptyline, a similar drug to Amitriptyline but with less side effects, and as it can cause constipation, I started taking two Movicol sachets a day and have had no problems. Within 2 weeks my pain is a lot better, the nausea has gone and so have my bladder problems. I started on 10mg and then after a couple of weeks have gone up to 20mg. I will continue using it as it is helping. I used it a few years back to get rid of vulvodynia which I'd had for 3 years. It was the only thing that worked.

[Iggls]

It may help with the symptoms of IBS D, but for IBS C it’s absolutely contra indicated! I was given it several years ago but it only took 3 days to seize my bowels up completely, so avoid it if that’s your problem.

[xjrs in reply to Iggls]

100% agree with you on that one Iggls .

[Zantecat]

Probably because it is prescribed off label at present so hasn’t got the science behind it ( basically what has already been said).

[Peaseloopy]

I'm taking amitriptyline for my fibromyalgia. I find it makes me tired. Sometimes a upset stomach. I don't understand why you are taking it for IBS

[xjrs in reply to Peaseloopy]

Personally I am not taking it for IBS - in fact I had a reaction to it. I know that it has been prescribed for IBS pain for years in low doses. Amitriptyline acts as a nerve pain agent in this instance. Additionally, it helps to rebuild pain control neurons in the brain, whereby the brain is erroneously picking up normal activity of the bowel as pain. Plus it can cause constipation, so it can help people with IBS-D as a side effect.

[Paulus]

Amitriptilyne was prescribed for me initially, to help with my IBS - D. It had the desired effect and I would hate to know how I would feel if didn't take it.I also know its primary function is as an anti depressant, which it also helped me with, especially after my dose was more than doubled from 10mg to 25mg.

Both my parents died within a a two year period and it helped me get through the stress of it all, which hasn't really ever left me.

It's horse's for courses I suppose, but amitriptilyne has been a lifesaver for me.

[xjrs in reply to Paulus]

Sorry to hear what you have been through and glad that it has helped you. My concern wasn't about the application of amitriptilyne in a medical setting. It was more to do with the fact that amitriptilyne has been knowingly used for IBS for years and some people have benefitted from it, which is great, but there are so many other things about IBS that need to be researched and answers found for, that I thought the money would have been better spent on those.

[LFHell]

I'd more like to ask them, why they would want to prescribe this as its a horrible drug that causes weight gain and depression! At least in me! I took it for 3 years for migraines. Maybe it even could have caused my fodmap intolerances as they occurred after that.

[xjrs in reply to LFHell]

Sorry to hear that.