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Which Tricyclic Antidepressant is best for IBS-D?

antidepressant tricyclic ibs-d diarrhea

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#21 ChrisRayd

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Posted 15 January 2018 - 08:20 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.

 

I would talk to your doctor about possibly using a very low dose of escitalopram( lexapro) with the nortriptyline.  I think the combination is relatively safe in low doses but of course you'd want to check with your doctor.  SSRI's are generally pretty good at managing IBS as well and the small dose of escitalopram would probably help with any constipation.  


Chris
 
 

#22 AZGuy

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Posted 15 January 2018 - 03:46 PM

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

 

Yes. just started Nortriptyline 2 days ago. So far so good. 



#23 AZGuy

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Posted 15 January 2018 - 03:50 PM

 

I would talk to your doctor about possibly using a very low dose of escitalopram( lexapro) with the nortriptyline.  I think the combination is relatively safe in low doses but of course you'd want to check with your doctor.  SSRI's are generally pretty good at managing IBS as well and the small dose of escitalopram would probably help with any constipation.  

 

Trust me. I'm loving the constipation at this point. My body always has a way of figuring itself back to loose stools after any treatment that is supposed to cause constipation. Like it works for a few days until my body catches on that I'm trying to trick it and then its back to the same old again. I'll see how this goes for a bit. I'm also on an anti-anxiety pill (clonazepam) which is helping for the anxiety which nortriptyline doesn't really address according to my shrink.



#24 ChrisRayd

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Posted 15 January 2018 - 05:48 PM

Lol ok sounds good to me. I hope your improvements continue and the constipation entirely goes away. I unfortunately know the feeling of having extreme bowel issues. Its a real pain in the a**( literally). Hope you have a good rest of your day.
Chris
 
 

#25 AZGuy

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Posted 27 January 2018 - 05:23 PM

Well just an update. Like always...after 2-3 days of good results my body figured it out and I was back on the toilet. So we upped the dosage from 10mg to 20mg and same thing. 2 days were ok (little more side effects like sleepiness and some irritability issues and some sexual dysfunction) but my bowels were ok until yesterday when it just all came out and no stopping it. Back to the imodium. Contacted both my gastro and psychiatrist who prescribed the Nortriptyline and they said that it shouldn't do that. Its constipating. So they suggested I stop it.

 

Sigh...now I'm not sure what to do. Both doctors didn't know either and asked what I wanted to do. It sucks when doctors have no clue and I have to do research. I think my next try will be getting away from the TCA family and trying something called Desyrel (Trazadone) which is an SARI anti-depressant. If not that maybe Remeron (Mirtazapine) or Wellbutrin (bupropion). I asked my shrink about the Wellbutrin cause I've heard good things and she said it probably wouldn't be good cause it can cause anxiety which I already take anti-anxiety meds for. 

 

The saga continues.



#26 RubyinMD

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Posted 28 January 2018 - 08:37 AM

Tricyclics didn't work for me either (amitriptyline and desipramine). I gave it a year. I'm about  to try Wellbutrin. My psychologist spoke highly of it as well, said it had the fewest side effects, but I hadn't heard that it causes anxiety sad.png  Mine is already off the charts. Now I'm not so sure I should take it.



#27 AZGuy

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Posted 28 January 2018 - 03:06 PM

Tricyclics didn't work for me either (amitriptyline and desipramine). I gave it a year. I'm about  to try Wellbutrin. My psychologist spoke highly of it as well, said it had the fewest side effects, but I hadn't heard that it causes anxiety sad.png  Mine is already off the charts. Now I'm not so sure I should take it.

 

Yeah, talk to him about it. The drug is also known to cause seizures in high doses. It rarely affects anyone cause the amounts must be high...but it is noted in its history. But millions of people take it for good results. A friend of mine takes it for depression and it helps but he mentioned his anxiety is off the charts. I think there is a connection between anxiety and IBS issues. I'm just trying to control both. But even being in a zombie state with meds doesn't curb the toilet issues for me. So I dont know. Good luck!



#28 minimalizer

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Posted 04 February 2018 - 02:04 AM

Cannabis (oil extract) improved my sleep when amitriptyline was causing nightmares right after falling asleep and wasn't helping my IBS-D that a GI said it would years ago, but didn't take until last year and stopped. Many people I've read saying they felt they had to take more and more, loosing it's efficacy. It was also extremely drying and I wanted my spit available to break down my food. I also eat an IBS-D diet/small frequent, well chewed meals and take soluble, soft, non-fermenting/no gas methylcellulose fiber to form/regulate bowel movements, buffers some spasming too. Two taken with 8 oz water before everything eaten, yes even with IBS-"D." Marketed as a laxative, but can also form stools in IBS-D. Anxiety can be caused by IBS-D, also by refluxing up and too much stomach acid. Cannabis is both anti-spasmotic and anti-inflammatory.


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.






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