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Discussion Starter · #1 ·
It has been 6 years since my life radically changed. I battled IBS for 9 years of my life having to quit 6 different jobs due to my symptoms and having been house bound for 1 year. I tried every medication and therapy I could find during those 9 years but to no avail. The only treatment which successfully treated my IBS was amitriptyline. I was never offered this medication as an option for my IBS during those 9 years even though many studies support its efficacy. I requested that my doctor prescribe this drug after finding success stories on similar IBS forums. I am wondering if others have had a similar experience as I have. During those 9 years I was prescribed many different anitidepressants (mostly SSRIs) even though there is little scientific evidence of these medications improving IBS-D. I am now 37 years old and living a full life as my symptoms radically improved after 6-8 weeks of beginning Elavil . I discontinued using this medication 2 years ago and my IBS has not returned. I would like to hear from anyone who has had a similar experience.
 

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What were your symptoms ? How it started ? Isn't Amitriptyline addictive ? I have an appointment with my GI in May and I'd like to ask him to put me on antidepressants as I read several succes story thanks to amitriptyline but I'm really not depressed and afraid to alter my mental health...
 

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Discussion Starter · #5 ·
It started in 2003 as post infectious IBS. I lost 60 lbs and was mostly house bound for the 1st year. I had neurological issues as well with myoclonus and muscular pain. I did not find amitriptyline to be addictive. I was only taking 25mg and when I came off of it the doctor did have me wean for about 2 weeks but I think I could have quit it cold turkey. I highly recommend trying it especially if you main problem is digestive pain. Sorry about taking long to respond. My computer died on me last week so I am sending this from work.
 

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Just a note about anti-depressants being "addictive": I think there is much confusion with anti-depressants and in general about "addiction" vs. physical dependence. Physical dependence basically means that if you were to abruptly stop taking the drug or medication, you would experience some degree of withdrawal symptoms. Physical dependence can occur with various medications, including anti-depressants and steroids. Of course, most addictive drugs can also cause physical dependence.

An episode of White Coat Black Art [which airs on CBC Radio One] was talking about physical dependence in anti-depressants and how there may be some patients who wouldn't have start treatment with anti-depressants if they knew how serious the withdrawal symptoms could be when a patient stops taking them. With various medications this may be a consideration in whether to initiate treatment, especially if you have IBS and the withdrawal symptoms can include diarrhea.

But addiction is really something different [though physical dependence can definitely be a factor in addiction]. Addiction has to do with the inability to stop a behavior in spite of the negative consequences associated with it. It may be tied in with physical dependence and have physiological causes, but physical dependence doesn't necessarily mean addiction. Even in the case of addictive drugs like opioids, there are patients who have to take opioids long enough to become physically dependent, but once they taper off of the medication they don't crave the medication or feel compelled to use it again.

In any case, I am curious if physical dependence has been a serious issue for anyone prescribed anti-depressants for IBS. I am under the impression that when these medications are prescribed to treat IBS, they are prescribed in lower doses than typically prescribed for the treatment of depression, so I would think that withdrawal symptoms would not be as much of an issue, especially if you taper off of the medication rather than abruptly stopping it.
 

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Amitriptyline was a huge success for me and I am still on everyday to treat my IBS-D - it does a lot of the heavy lifting in my daily medication regime.

Required some patience and commitment to stay on it a few months and increase dosage - to a point where I was having side effects - but I would say within about 4-6 weeks even on 10mg daily I was already seeing a big improvement and after adjusting to a higher dose, it is still the most effective thing I have tried (of medications, supplements, dietary changes) in reducing urgency.

I went from having to run to the nearest bathroom (and anxiety leaving home/being trapped at a location for hours), postponing meals etc. to having plenty of warning and being able to eat more freely and go on with my day, drive, go into meetings without a worry.

I stepped up the dose over time in consultation with my doctor.

I was wary about longer term health risks and I didn't really want to be reliant on antidepressants long term. In terms of immediate side effects, I have found it causes nausea on an empty stomach and makes me sleepy, I was on 50mg a day which was quite high dose, made me just about fall off my chair about 90 mins after taking it (so if you do try it, take it before bed and do not drive), and felt a bit foggy all day and would start to fall asleep at work. It was not the type of antidepressant that makes you feel shiny and happy, it left me numb and very tired (but I slept like a log!). BUT that is not to scare you off just to let you know like anything, there are pros and cons, and it's about optimising what works for you.

it has been such a big part of getting my life back to normal that I ended up reducing my dose to 25mg (verrrrrry slowly) and whilst the effect is lesser now, I now have other medications in the mix which mean I have a pretty normal day.

Couple of other observations: In my experience double the dose does not equal double the effect (if that helps). And watch other medication interactions: just give it a quick google before you take something new or in combination with it.

So my experience was part of the solution (at least medium term) but not a cure.

Happy to answer questions if I can.
 

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Hi Raz37, thank you for sharing your experience.
You mentioned that you had 60lbs weight loss (thats a lot of weight). I am also suffering from PI IBS D and have lost 15KG in last one year.
So when your doctor put you on Amitriptyline, did you start regaining your weight?
I am getting very depressed with this weight loss and have to leave my job too.
Any suggestions....
 

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Tarun,
In my thoughts weight loss is not due to ibs-d.it may occur one or two kegs due to eating fear.weight loss is not a cause of ibs-d
It is very difficult to gain weight in ibs-d.
I am under weight I tried many things to gain my weight but invain.
Take care.
 

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The Rome Foundation, a group of gastros who determine the criteria for ibs, has published a paper this year to get word out to more doctors that neuromodulating drugs can treat ibs pain. They recommend TCAs and SNRI's as first line treatment for pain, with aa's and anticonvulsants as adjuncts. One thing to note is that drug metabolism varies. This can determine whether the drug reaches an effective serum level or causes side effects. I am an ultra rapid metabolizer of TCAs so I am taking 200mg of amitriptyline, so far, with much improvement.

Neuromodulators for Functional Gastrointestinal Disorders (Disorders of Gut-Brain Interaction): A Rome Foundation Working Team Report

Central Neuromodulators for Treating Functional GI Disorders: A Primer

These two paper contain current recommendations for ibs pain.
 

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Discussion Starter · #13 ·
The Rome Foundation, a group of gastros who determine the criteria for ibs, has published a paper this year to get word out to more doctors that neuromodulating drugs can treat ibs pain. They recommend TCAs and SNRI's as first line treatment for pain, with aa's and anticonvulsants as adjuncts. One thing to note is that drug metabolism varies. This can determine whether the drug reaches an effective serum level or causes side effects. I am an ultra rapid metabolizer of TCAs so I am taking 200mg of amitriptyline, so far, with much improvement.

Neuromodulators for Functional Gastrointestinal Disorders (Disorders of Gut-Brain Interaction): A Rome Foundation Working Team Report
Central Neuromodulators for Treating Functional GI Disorders: A Primer

These two paper contain current recommendations for ibs pain.
Really fantastic info. Hopefully the word gets out there and improves the lives of many people suffering from this awful disorder.
 

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Discussion Starter · #14 ·
Hi Raz37, thank you for sharing your experience.
You mentioned that you had 60lbs weight loss (thats a lot of weight). I am also suffering from PI IBS D and have lost 15KG in last one year.
So when your doctor put you on Amitriptyline, did you start regaining your weight?
I am getting very depressed with this weight loss and have to leave my job too.
Any suggestions....
Sorry I never posted. My computer has died on me 3 times due to various issues. My weight wildly fluctuated for the 9 years I was ill, ranging between 145 lbs and 205 lbs. I am 6'3". When I began the amitriptyline, I was about 160lbs and very weak. I gained 30lbs within about 2-3 months as food began feeling like food again and less like eating a box of thumb tacks. I hope the meds are helping and if not, maybe it is worth upping the dose or trying an SNRI as alluded too in the medical literature Penzel suggested. It seems like the medical community has really began making serious headway with IBS pain management.
 

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What were your symptoms ? How it started ? Isn't Amitriptyline addictive ? I have an appointment with my GI in May and I'd like to ask him to put me on antidepressants as I read several succes story thanks to amitriptyline but I'm really not depressed and afraid to alter my mental health...
It was not addictive, at least compared to other drugs like benzodiazepines . When I discontinued the use of Ami I did taper off from it, but it was very easy. No side effects. Probably could have just quit cold turkey. I also wasn't depressed except the fact that being ill had ruined my life for 9 years. They are used because of there efficacy in modulating nuerotransmitters. The gut (second brain) contains 100 million nuerons. This helps expain why these meds are so effective in treating bowel disorders.
 
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