Which Tricyclic Antidepressant is best for IBS-D? - IBS Diarrhea (IBS-D) - IBS Self Help and Support Group Forums - IBSgroup.org
Advertisement

Jump to content


Photo

Which Tricyclic Antidepressant is best for IBS-D?

antidepressant tricyclic ibs-d diarrhea

  • Please log in to reply
27 replies to this topic

#1 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 15 November 2017 - 12:55 AM

Advertisement

I've been suffering from chronic diarrhea for over a decade now. Every test I've ever taken has come back negative...but I have all the symptoms of Crohn's Disease or some form of IBD. Of course every gastro doctor I see has a different opinion. Some say yes, its Crohns, others say no...its just IBS-D. Some say its an IBD that just hasn't presented itself yet. I've been on every drug there seems to be. Asacol, Pentasa, Imuran, Cellcept, Humira, Bentyl, Levbid, Xifaxan, Viberzi and more. I've tried a few antidepressants in the past that never really worked and only gave me undesirable side effects. So I'm ready to revisit the antidepressants.

 

I know the tricyclic antidepressants are for people with IBS-D. So I'm curious out of all the ones out there...which one worked best for you in terms of bringing your bowel habits back to normal?



#2 ccoleman

ccoleman

    Regular Member

  • Members
  • PipPip
  • 70 posts
  • Country:United States

Posted 15 November 2017 - 01:17 AM

Low doses of desipramine (50-100 mg) or amitriptyline (25-75 mg) appear to be effective in controlling symptoms



#3 RubyinMD

RubyinMD

    Regular Member

  • Members
  • PipPip
  • 58 posts

  • IBS Penpal
  • Country:United States

Posted 15 November 2017 - 05:36 AM

Neither desipramine nor amitriptyline worked for me. (I'm about to start and SSRI in the hope of correcting a possible mental component. If that doesn't work,  well, then not sure what happens next). I hung in with the tricyclics for a year a half, uppping the dosage and hoping it would work.

 

I found the desipramine to not give me the weird dreams like amitriptyline did.

 

Good luck! Let us know if it works for you.



#4 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 16 November 2017 - 10:07 AM

Yes..I remember I did have weird dreams, but moreso, I felt my heart racing, with amitriptyline (Elavil). I never had much luck with the SSRIs because they increase the serotonin in the body which naturally makes your motility work faster. So that meant more bathroom issues. For a guy with IBS-D...that was pointless.



#5 dekkalife

dekkalife

    Prolific Member

  • Members
  • PipPipPip
  • 243 posts
  • Country:Canada

Posted 16 November 2017 - 12:01 PM

I found that antidepressants in general did little to nothing for my IBS, and came with a plethora of annoying side effects. Having said that, IBS is especially frustrating in that, one man's meat is another man's poison. Amitriptyline certainly has the most research in the treatment of IBS, but I would say that any tricyclic antidepressant probably has a similar likelihood of benefiting you. I've read people praising Amitriptyline, others Imipramine, and Nortriptyline. If Tianeptine was available, I might give that a go.



#6 joeyr2

joeyr2

    Prolific Member

  • Members
  • PipPipPip
  • 112 posts
  • Country:United States

Posted 21 November 2017 - 11:12 AM

I've been suffering from chronic diarrhea for over a decade now. Every test I've ever taken has come back negative...but I have all the symptoms of Crohn's Disease or some form of IBD. Of course every gastro doctor I see has a different opinion. Some say yes, its Crohns, others say no...its just IBS-D. Some say its an IBD that just hasn't presented itself yet. I've been on every drug there seems to be. Asacol, Pentasa, Imuran, Cellcept, Humira, Bentyl, Levbid, Xifaxan, Viberzi and more. I've tried a few antidepressants in the past that never really worked and only gave me undesirable side effects. So I'm ready to revisit the antidepressants.

 

I know the tricyclic antidepressants are for people with IBS-D. So I'm curious out of all the ones out there...which one worked best for you in terms of bringing your bowel habits back to normal?

The generally accepted medicinal effects are that tricyclics slow things down and SSRI's generally speed them up.  In my case I've tried them all and none of them had even a slight affect on my symptoms.  As far as the tricyclics I preferred nortrip to amtrip as nortrip keeps me awake with more energy and amtrip puts me to sleep. 



#7 minimalizer

minimalizer

    Prolific Member

  • Members
  • PipPipPip
  • 266 posts
  • Country:United States

Posted 23 November 2017 - 05:46 PM

If you're in AZ and can get medical marijuana RSO form of it easily here, I'd do that. I take it for flare-ups. Might take it ongoingly. Actually helps you get off anti-depressants. I'm similar to you from what I can tell without your health profile done;One of 2 GIs told me I have a severe inflammation, started to call it crohn's/gave me pentasa anti-inflammitory for just a month, felt better, then sent me back to the general practitioner, saying see you in 6 mos, with no sooner appointments avail. Before that 6 mos. time I got worse. Second GI said not as granular as crohn's and prescribed Elavil. He wanted to prescribe Alosetron/Lotronex but it was off the market;Hard to get and expensive out of pocket. The same area of pain flares up now since 17 yrs ago. Plus the IBS-D, but more controlled with that. I have never had blood. I probably have SIBO, unknown back then, with IBS-D. I take enzymes more than probios with that in mind.


1/04/18: Pain's my main problem. IBS-D prone, but not with methylcellulose soluble non-gassy caplets still, 2 before anything eaten.  Also, 10C water/day (Have to if taking fiber supplement and soluble foods). Frequent, small and well chewed meals. No more salads, seeds or peel, whole grains, raw vegetables STILL. Have used in the past antispasmotics, low dose tricyclic anti-depressent (for ibs and inflammation)/both VERY drying even at low amounts and disorienting, CBD oil and IBgard's encapsulated peppermint (works better than older type enteric peppermint). Have occasional inflammation in illium at end of small intestine, but it was not crohns. Activated charcoal when needed for flatulence, simethicone only works on upper stomach area for upper gas (burping) right away btw, not flatulence at end of g.i. track. Tried Kratom, good but itchy and didn't prevent a flare up from eating a wrong foods. Raising dosage didn't kick down inflammation. Now back to being certified for (legally available here) medical high CBD Cannabis/Marijuana RSO (thick oil form), more expensive. I needed more anti-inflammitory help from the THC in regular cannabis oil, instead of just CBD oil.


#8 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 23 November 2017 - 07:47 PM

I'm hesitant to take marijuana cause I don't feel it would benefit me much. I dont have abdominal pains unless I have the runs really bad and then those are just the diarrhea pains everyone gets. So I dont see how it would help me. The main goal here is to slow down my motility. I did one of those transit tests and it showed I have a very rapid transit...but not much can be done for it. I too tried to get on Lotronex but I couldn't since its prescribed only for women. Insurance wouldn't cover it. So everything is perplexing to everyone.

 

I just started sticking to the FODMAP diet hardcore so I'll see how that plays out. I did do a hydrogen breath test years ago. It was positive and back then they had me on all sorts of antibiotics which in the end I think made me worse. Was on the Xifaxan for 3 weeks with no effect. I keep trying probiotics and different strains but they make me go worse. So right now...imodium is still my only survival drug. But it does little for my excessive, methane-like gas, which I find to be a huge hindrance for me for any type of social or intimate relationships. 

The psychiatrist I just saw has me reading some depression books which is all fine and good. But its not going to do anything than teach me to accept my situation which I refuse to accept.



#9 minimalizer

minimalizer

    Prolific Member

  • Members
  • PipPipPip
  • 266 posts
  • Country:United States

Posted 23 November 2017 - 10:15 PM

Enzymes for SIBO to digest most food carbs before overgrowth of bacteria feeds on it. But bacteria overgrowth can also feed on food fiber and some fiber supplements, but not soft soluble non-gassy methylcellulose (treated, so can't be fermented), which can help regulate both kinds of IBS in case you haven't tried it. Have to drink alot of water to work. Tried Elavil 25mg, extremely drying, bad dreams and very hard concentration too. Didn't help IBS-D with inflammation. Wondering if there were prebiotics (which can feed bad bacteria too) in any of the probiotics or if they had too high of potency count, which aren't helpful for SIBO. Ten billion is all I take daily. I like cannabis. It is anti-bacterial and anti-inflammatory, so I take the low probiotics separately.


1/04/18: Pain's my main problem. IBS-D prone, but not with methylcellulose soluble non-gassy caplets still, 2 before anything eaten.  Also, 10C water/day (Have to if taking fiber supplement and soluble foods). Frequent, small and well chewed meals. No more salads, seeds or peel, whole grains, raw vegetables STILL. Have used in the past antispasmotics, low dose tricyclic anti-depressent (for ibs and inflammation)/both VERY drying even at low amounts and disorienting, CBD oil and IBgard's encapsulated peppermint (works better than older type enteric peppermint). Have occasional inflammation in illium at end of small intestine, but it was not crohns. Activated charcoal when needed for flatulence, simethicone only works on upper stomach area for upper gas (burping) right away btw, not flatulence at end of g.i. track. Tried Kratom, good but itchy and didn't prevent a flare up from eating a wrong foods. Raising dosage didn't kick down inflammation. Now back to being certified for (legally available here) medical high CBD Cannabis/Marijuana RSO (thick oil form), more expensive. I needed more anti-inflammitory help from the THC in regular cannabis oil, instead of just CBD oil.


#10 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 23 November 2017 - 10:51 PM

What kind of soluble non-gassy methyl cellulose fiber are you talking about? Never heard of it. Is there a brand you take? What probiotic do you take? As for probiotics I've tried a lot of different ones over the years. Even that stuff from the pharmacy. VLS#4 or something. Currently I'm taking Gastrus by Biogaia and Align but will stop it when I run out.

I used to take a food enzyme called Pancreatin. But the more I'm reading...if a person already has digestive issues like leaky gut, or other damaged intestinal issues...you should get that solved before the digestive enzymes. Again...I feel like I get a different answer from everyone I see.



#11 minimalizer

minimalizer

    Prolific Member

  • Members
  • PipPipPip
  • 266 posts
  • Country:United States

Posted 24 November 2017 - 01:55 AM

Walmart's Generic Equate methylcellulose caps, 2 before anything eaten with 8 oz a water/It relies on water to weight it through. Otherwise, if you took it as a drink mix, it would include alot of sugar for the amount needed for IBS, or artificial sugars (causes diarrhea and/or gas) and isn't as convenient. Also, smaller, frequent well chewed meals is important. Otherwise I would really have diarrhea. Haven't had diarrhea for years. Usually I have a healthy 2X/day BMs. Sometimes I'll have an extra bowel movement, but they have form, just skinnier, "never watery." Pancreatin is for protein, and yes I heard it can irritate sensitive tissues. I'm talking about enzymes that can help digest most carbs and maybe some that "somewhat" help break down fiber. Don't think there's any enzyme for fructose, to replace fructase people can be deficient in. Wish there was to try, hence some of FODMAP diet helps. I take the basic daily 10 bill. of acidophillus and bifidus. Higher than 10 billion causes too much die off too quickly, as with prebiotics, then the gas-then diarrhea prone more, even though utilized activated charcoal to absorb some die off gas. They are low histamine causing probios. I went through VSL#3 and Align, and also the non-prebiotic as well version of Culturelle and others, no luck. No probiotics over 17 years ever solved any IBS-D or pain with it. But if I have SIBO, it's said to be too much probiotic in the sm intestine that gets to the food before enzymes there do and causes unfavorable alkaline environment and irritates, so makes sense to take carb. digesting enzymes at least. Most of the probios are transient, so don't think ones that stick around longer would make sense for SIBO. Can't do much about food fiber being fermented in the wrong spot and also the colon, except go on a low residue diet. White rice and a lean protein is what people do temporarily (2 days?) to de-flare, slows things down and no excess gas, even if just IBS-D that really helps, but I would take the non gassy methylcellulose with it to prevent blood sugar swinging. I learned that from the Eating For IBS Diet that I have to tweek. Can't do some of the foods on the diet, definitely no whole grain, seeds or peel, lettuce or any rough raw produce, or gassy foods. For some people too much fat at the beginning of the meal can cause food rushing downline. Anyway hope that helps, even with elaborating too muchblush.png , speaking to all who might read this. Immodium might slow things down, but can hold up bacteria too much and doesn't help strengthen the colon muscles like a non-gassy fiber, and lower food fiber (yet more on the soluble fiber foods side) diet idea to help with an area that has lost muscle tone and is flacid following infection or from age. Course, IBS can be caused by a bad back causing just a motility problem, but then can eventually build up bacteria in one spot.


Edited by minimalizer, 24 November 2017 - 03:22 PM.

1/04/18: Pain's my main problem. IBS-D prone, but not with methylcellulose soluble non-gassy caplets still, 2 before anything eaten.  Also, 10C water/day (Have to if taking fiber supplement and soluble foods). Frequent, small and well chewed meals. No more salads, seeds or peel, whole grains, raw vegetables STILL. Have used in the past antispasmotics, low dose tricyclic anti-depressent (for ibs and inflammation)/both VERY drying even at low amounts and disorienting, CBD oil and IBgard's encapsulated peppermint (works better than older type enteric peppermint). Have occasional inflammation in illium at end of small intestine, but it was not crohns. Activated charcoal when needed for flatulence, simethicone only works on upper stomach area for upper gas (burping) right away btw, not flatulence at end of g.i. track. Tried Kratom, good but itchy and didn't prevent a flare up from eating a wrong foods. Raising dosage didn't kick down inflammation. Now back to being certified for (legally available here) medical high CBD Cannabis/Marijuana RSO (thick oil form), more expensive. I needed more anti-inflammitory help from the THC in regular cannabis oil, instead of just CBD oil.


#12 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 24 November 2017 - 02:24 AM

Thanks for all the information. Its always good to hear other peoples experiences. I will look into the methycellulose caps and go from there. So far I feel like I've been doing a tad better on FODMAP and the L-Glutanine. But its not unusual for my body to react positively to something new only to get used to it and back to the same old situation. Thanks!



#13 minimalizer

minimalizer

    Prolific Member

  • Members
  • PipPipPip
  • 266 posts
  • Country:United States

Posted 24 November 2017 - 03:11 PM

Thanks for all the information. Its always good to hear other peoples experiences. I will look into the methycellulose caps and go from there. So far I feel like I've been doing a tad better on FODMAP and the L-Glutanine. But its not unusual for my body to react positively to something new only to get used to it and back to the same old situation. Thanks!

Welcome and Yah, I hear that! Makes me wonder if bacteria keep getting use to feeding on other things again and again. Hoping you keep doing even better with what is helping ease things.


1/04/18: Pain's my main problem. IBS-D prone, but not with methylcellulose soluble non-gassy caplets still, 2 before anything eaten.  Also, 10C water/day (Have to if taking fiber supplement and soluble foods). Frequent, small and well chewed meals. No more salads, seeds or peel, whole grains, raw vegetables STILL. Have used in the past antispasmotics, low dose tricyclic anti-depressent (for ibs and inflammation)/both VERY drying even at low amounts and disorienting, CBD oil and IBgard's encapsulated peppermint (works better than older type enteric peppermint). Have occasional inflammation in illium at end of small intestine, but it was not crohns. Activated charcoal when needed for flatulence, simethicone only works on upper stomach area for upper gas (burping) right away btw, not flatulence at end of g.i. track. Tried Kratom, good but itchy and didn't prevent a flare up from eating a wrong foods. Raising dosage didn't kick down inflammation. Now back to being certified for (legally available here) medical high CBD Cannabis/Marijuana RSO (thick oil form), more expensive. I needed more anti-inflammitory help from the THC in regular cannabis oil, instead of just CBD oil.


#14 minimalizer

minimalizer

    Prolific Member

  • Members
  • PipPipPip
  • 266 posts
  • Country:United States

Posted 24 November 2017 - 06:44 PM

Methylcellulose (absorbs excess water in colon/makes formed stools, and don't be concerned if marketed for/or says constipation or as laxative) can be taken long term and is treated cellulose so won't cause gas. If when things slow down you get excess gas, it's either from not drinking enough water and consistently throughout the day to move this soluble fiber supplement through, or you aren't ready for the level of  soluble "food" fiber yet you ate for the day. I've juiced fresh produce before with no fiber inherent in it, except taking the methylcellulose, and had no excess gas for the day. So, not always do just carbs cause problems. Methylcellulose helps moved along gas trapped from IBS spasming, especially if can't get to your meal soon enough.


  • AZGuy likes this

1/04/18: Pain's my main problem. IBS-D prone, but not with methylcellulose soluble non-gassy caplets still, 2 before anything eaten.  Also, 10C water/day (Have to if taking fiber supplement and soluble foods). Frequent, small and well chewed meals. No more salads, seeds or peel, whole grains, raw vegetables STILL. Have used in the past antispasmotics, low dose tricyclic anti-depressent (for ibs and inflammation)/both VERY drying even at low amounts and disorienting, CBD oil and IBgard's encapsulated peppermint (works better than older type enteric peppermint). Have occasional inflammation in illium at end of small intestine, but it was not crohns. Activated charcoal when needed for flatulence, simethicone only works on upper stomach area for upper gas (burping) right away btw, not flatulence at end of g.i. track. Tried Kratom, good but itchy and didn't prevent a flare up from eating a wrong foods. Raising dosage didn't kick down inflammation. Now back to being certified for (legally available here) medical high CBD Cannabis/Marijuana RSO (thick oil form), more expensive. I needed more anti-inflammitory help from the THC in regular cannabis oil, instead of just CBD oil.


#15 Christine21

Christine21

    New Member

  • Members
  • Pip
  • 3 posts
  • Country:New Zealand

Posted 10 January 2018 - 03:59 AM

Hi, I'm not sure if you are still wanting answers to your question, my med is Clomipramine, used for General Anxiety and phobic disorders - my phobia is vomiting, and any anxiety would always have me running to the bathroom with diarrhea, however these meds have been amazing for me. I have been on them for over 15 years now, one of the things that was helpful is that they come in small doses so I could start with 10mg and build up, I currently take 50mg and feel okay.

I hope you find something that helps you. 



#16 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 10 January 2018 - 04:40 AM

Hi, I'm not sure if you are still wanting answers to your question, my med is Clomipramine, used for General Anxiety and phobic disorders - my phobia is vomiting, and any anxiety would always have me running to the bathroom with diarrhea, however these meds have been amazing for me. I have been on them for over 15 years now, one of the things that was helpful is that they come in small doses so I could start with 10mg and build up, I currently take 50mg and feel okay.

I hope you find something that helps you. 

 

I have heard about that drug and how its very popular with people with IBS-D. (I'm curious if it cures the urgency that we often get. Sometimes that is worse that actually going.)

Unfortunately most insurances don't cover clomipramine or I have a $95 co-pay which is just out of budget for me. I saw my doctor and we're proceeding with the Nortriptyline to give that a try. I'm awaiting to pick up the drug now!



#17 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 10 January 2018 - 04:45 AM

Course, IBS can be caused by a bad back causing just a motility problem, but then can eventually build up bacteria in one spot.

 

I've never heard that IBS can be caused by a bad back and cause motility issues. I do have pretty bad lower back pains which some doctors have called anklosing spondylitis while other rheumatologists discredit that. In either case...I do have lower back pain and often when I'm having a really bad day I'm having much worse pain. Ironically...all my issues started when I had an inguinal hernia repair 13 years ago. I'm often wonder if that trauma on my intestines caused all this and its just never been the same.



#18 minimalizer

minimalizer

    Prolific Member

  • Members
  • PipPipPip
  • 266 posts
  • Country:United States

Posted 14 January 2018 - 11:00 PM

https://www.webmd.com/drugs/2/drug-1305/clomipramine-oral/details


1/04/18: Pain's my main problem. IBS-D prone, but not with methylcellulose soluble non-gassy caplets still, 2 before anything eaten.  Also, 10C water/day (Have to if taking fiber supplement and soluble foods). Frequent, small and well chewed meals. No more salads, seeds or peel, whole grains, raw vegetables STILL. Have used in the past antispasmotics, low dose tricyclic anti-depressent (for ibs and inflammation)/both VERY drying even at low amounts and disorienting, CBD oil and IBgard's encapsulated peppermint (works better than older type enteric peppermint). Have occasional inflammation in illium at end of small intestine, but it was not crohns. Activated charcoal when needed for flatulence, simethicone only works on upper stomach area for upper gas (burping) right away btw, not flatulence at end of g.i. track. Tried Kratom, good but itchy and didn't prevent a flare up from eating a wrong foods. Raising dosage didn't kick down inflammation. Now back to being certified for (legally available here) medical high CBD Cannabis/Marijuana RSO (thick oil form), more expensive. I needed more anti-inflammitory help from the THC in regular cannabis oil, instead of just CBD oil.


#19 AZGuy

AZGuy

    Prolific Member

  • Members
  • PipPipPip
  • 236 posts

  • IBS Penpal
  • Country:United States

Posted 15 January 2018 - 03:54 AM

 

 

Actually I have heard about that drug, but my formulary doesn't it. I think I could get it for about $100 a month, but that's too much for my budget.

I started on the nortriptyline yesterday. And I was happy to say I had little side effects (except maybe some tiredness) but overjoyed I was somewhat constipated. So that is thrilling for someone with IBS-D. We will see if it continues.


  • minimalizer likes this

#20 ChrisRayd

ChrisRayd

    Regular Member

  • Members
  • PipPip
  • 32 posts

  • IBS Penpal
  • Country:United States

Posted 15 January 2018 - 08:02 AM

Tofranil (Imipramine) or Pamelor(Nortriptyline) are probably the best ones that you could use if you're up for trying them.  


  • AZGuy likes this
Chris
 
 





Also tagged with one or more of these keywords: antidepressant, tricyclic, ibs-d, diarrhea


Advertisement

About Us | Contact Us | Advertise With Us | Disclaimer | Terms of Service | Crisis Resources

Irritable Bowel Syndrome |  Inflammatory Bowel Disease |  Crohn's Disease |  Ulcerative Colitis |  Fibromyalgia |  GERD - Reflux Disease


©Copyright 1995-2016 IBS Self Help and Support Group All rights reserved




This website is certified by Health On the Net Foundation. Click to verify. We comply with the HONcode standard for trustworthy health information: verify here