# which antidepressants for IBS-C?



## Nuffa (Sep 12, 2014)

hi again,

I am suffering from ibs-c and slow transit. my psyche is also a huge problem as a result of all the pain,impactions, constipation and so on.doctors prescribed me two antidepressants.One is called cymbalta and the other Dioxepin. Do they slow down gut motility even more? my psychologist says they do.Any expierence with other antidepressants that possibly accelerate gut motility as a side effect at the same time reducing pain?

thanks!


----------



## Tricis56 (Sep 5, 2014)

HI

I have been asking this as well for a long time with no answers. I am on Cymbalta (Duloxetine ) and decided to start reducing it because of the slow transit. There doesn't really seem to be a better one to replace it though. I have now reduced it to 30 mg in the morning, although my Consultant says at this strength I may as well not be taking it at all, but I found it very difficult to come off it so am doing it really slowly.


----------



## annie7 (Aug 16, 2002)

i have seen zoloft (sertraline), celexa (citalopram), and prozac (fluoxetine) mentioned here on the board as being helpful for people with constipation. not sure if these meds are available in your respective countries.

celexa is also supposed to help with pain relief. not sure about the others.

and of course, with antidepressants--as with any meds--we're all so different in how our bodies react to drugs--what helps one person may not help another etc...

hopefully someone else with experience in taking these or other anti-d's will post here.


----------



## Nuffa (Sep 12, 2014)

I only have psychological problems due to ibs,which means i could try to take half a pill. Tricis,wishing u all the best! Keep us posted! Annie for president!😄thanks a lot!


----------



## flossy (Dec 8, 2012)

I was on Wellbutrin XL several years ago and not long ago tried taking it again, because I was bummed out about my IBS-C. It definitely helped with the blues but slowed down my insides even more, so I quit taking it.

For me, exercising between 4 to 6 times a week (I lift weights) helps keep my spirits up just as much as antidepressant meds keep me from being down.


----------



## LindaFoster (Oct 9, 2014)

Flossy, I give you so much credit. for keeping up your workouts. I also have psyc deprression due to the IBS-C, which started 5 months ago. I was such an active person, hiking, travel, working etc. I can barely work part time and Now, it's the nothing no activity whatsoever, I can't think anymore. This has taken over my life and I hate it. Can't eat bcus i bloat and pass the gas. Been to doctor after doctor all the tests. I also have a low functioing gall bladder. Tried everything, medimucille, magnesium citrate, (which leaves me dehyrated) even juicing. I have lost almost 22 lbs and am skin and bones. i was wondering what the rest of you do for the gas and the bloat. i take the mom but it does not seem to be working very well any more. I almost envy the ones with the ibs D at least you can get the stuff out right? My doc wants me on anitdepresaints also and I was wondering the same thing will that constipate you even more?


----------



## flossy (Dec 8, 2012)

I don't have gas any more often then when I didn't have IBS-C, but if I need 'help' with that I use Beano and Equate Gas Relief (Simethicone - 125 mg, 3 of them).


----------



## LindaFoster (Oct 9, 2014)

Flossy, when you said "when you did have the IBS C" did you finally get over that? Sounds like you did not let it run your life which is an amazing thing. i want to get my strenght back so bad so that I can at least go back to the gym. I actually have 2 problems, the IBS and the gall bladder, and no appitite, when I get "backed up" Doctor still thinks i should have the gall bladder taken out, but no garantees, pretty scary, so we will see. What kind of foods do you eat? Do you still have an appittite? I do use the gas X but it does not seem to work very well, maybe I will try the beano. Thanks.


----------



## flossy (Dec 8, 2012)

Sorry LindaFoster, but my sentence was incorrect. It said, "I don't have gas anymore then when I did have IBS-C."

What I meant to type was, "I don't have gas anymore often then when I didn't have IBS-C."

Sorry! I screwed up.


----------



## flossy (Dec 8, 2012)

LindaFoster said:


> Flossy, when you said "when you did have the IBS C" did you finally get over that? Sounds like you did not let it run your life which is an amazing thing. i want to get my strenght back so bad so that I can at least go back to the gym. I actually have 2 problems, the IBS and the gall bladder, and no appitite, when I get "backed up" Doctor still thinks i should have the gall bladder taken out, but no garantees, pretty scary, so we will see. What kind of foods do you eat? Do you still have an appittite? I do use the gas X but it does not seem to work very well, maybe I will try the beano. Thanks.


Oh, I always have an appetite. lol. I eat normal foods, like meat, soup, cereal, chicken, sandwiches, stuff like that. Soup is easiest for me to digest (chicken soup).

I have a post here, my original one, if you wanna read it it's right here (and sorry it's so long!):

http://www.ibsgroup.org/forums/topic/187162-my-ibs-c-story/


----------



## Kathleen M. (Nov 16, 1999)

Generally the SSRI's seem more likely to speed things up (cause diarrhea). SNRI's and tricyclics seem more likely to slow things down.


----------



## Nuffa (Sep 12, 2014)

Thanks. But do i get this right: both types of antidepressants can help with pain,cant they?


----------



## annie7 (Aug 16, 2002)

Kathleen knows more about this than i do.....

...i have read studies that said that celexa (citalopram) can help with pain relief as well as help with constipation. of course, as i said before, your mileage may vary.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1192434/?report=classic

the following article is about anti-d's and ibs and pain relief.

http://www.webmd.com/depression/tc/antidepressants-for-irritable-bowel-syndrome-topic-overview


----------



## Jinky (May 23, 2014)

I take Celexa and it has made my constipation worse. Side effects are not guaranteed with any medication, and in terms of increasing transit, be careful what you wish for. You will likely go in the other direction ('D').

The "use an SSRI for C to speed things up' as a "rule" is incorrect. Some people have no G.I. problems with this class of medications. Some get D. Some get C. My G.I. symptoms with Zoloft (an SSRI) were so

bad I had to discontinue. I got D, bloating and ab pain. Celexa is an SSRI as well. I have to double my dose of MOM to get things moving. Go figure! One thing is true, tricyclics are notoriously constipating, some

worst than others, depending on which receptors get hit the hardest. Amntriptyline the worst, Nortriptyline a close second.

I'm not a psychiatrist, but I have been working directly with the mentally ill for 12 years, so I have some clinical experience behind me, besides myself. I consult with the psychiatrists, treat, review, and document on a daily basis.

EDIT: In terms of G. I./ constipation pain relief, the only anti-depressant medications that have been studied and/or have indications for pain are the Tricyclic class of meds, most specifically Amnitriptyline and Nortriptyline, and

Cymbalta. I'm not aware of their benefit for G.I. related pain, I can't imagine the Tricyclics are useful since they cause constipation and Cymbalta is indicated for muscoskeletal pain, not visceral pain. But maybe

others have had benefit from them. From my knowledge they are not commonly used to treat that problem.


----------



## ChooseJoy926 (Oct 26, 2014)

So let me start by saying that I have just found this whole site and I am so glad. But I am very new to it. But I can tell you all that I have been there and done it all! I feel your pain and frustration. But hopefully I can share a few things that may help.

First, the most important thing to remember with this lovely condition although we may be classified within a similar group - I can tell you from my experience at each and every person is 100% different. This is why treatments and therapy is so difficult to find.

Second, I have a whole bunch of fun additions that I get to enjoy as well. I was actually diagnosed with IBS about 12 years ago, and at that time there were no groups or any differentiations. It was what doctors told you when they couldn't come up with anything else. Now in addition I do have ADHD, anxiety disorder, depression, and chronic fatigue syndrome so I am a whole bunch of fun! When I was diagnosed I actually had the symptoms of IBS-D and it was also discovered I have gastroparesis. (My stomach empties very slowly)

For a while everything was great I was sleeping, my stomach was semi under control, my mood was stable, and I could function pretty normally on a day to day basis. I was on Celexa for anxiety and depression, amitriptyline to sleep and chronic pain, and then Vyvanse and Adderall. However, something in the last 4-6 months changed. It was awful! I went to the exact opposite end of the spectrum and now have begun seeing another doctor and they have classified me in the IBS-C category.

They wanted me off of amitriptyline, and I tried everything but I can't get a good nights sleep without taking some of it. I was at a 100 my dose and I am now taking 15 mg. I also take melatonin 3 my, and .25 mg of clonozepam. I think that's the magic dose for sleep. My new doctor has put me on Linzess and it at least is making things move, but the pain and gas is still horrible. I also began having extremely bad heartburn symptoms which had never been an issue. We finally figured out that the Celexa was causing it and going off of it helped immediately. It also reduced some of the GI issues but not all.

Couple of other tips that make a HUGE difference: take probiotic and a good one. I had been taking one but it was just the cheap one from Kroger. Switching to one that has 25 billion organisms has made a difference. I know when I forget to take it. Another great addition, because I take my probiotic in the morning, is taking a digestive enzyme with lunch and dinner. (I take Ultra Flora Womans probiotic and digest extra - vitamin shoppe) and it helps. Also, I try and drink juice or coffee in the morning and I add some fiber to whatever I have. I probably use about 1/4 of what's suggested but any more doesnt help! When I am having a bad day and things aren't going well ginger is always my go to.

I found that only a pure stool softener is helpful with the C. You do not want any type of laxative and I stay away from mom and mag ciltrate, and even miralax. You are probably thinking crazy.... I can't do that... But the reason is that using those types of products you are actually further your system to continue to block up. Using Aloe Vera juice and ginger along with probiotics and activity allows your system to reboot and remember how to properly work. Does that mean it won't happen again? No but slowly you can train your gut to move things along.

If you are looking for relief one the best medicines I ever used was dicyclamine. It's a relaxant for your stomach muscles - it really helped me. Hycosomine was another good one.

Now, as for the anti-Ds - I am currently fighting that battle as we speak. I am currently on Lexapro but that's not working. So I am trying to research some other options. Anyone with ADD-ADHD cymbalta is not one I would even try! It interacts with a lot of add drugs and constipation is one of its top side effects. Celexa has this side effect too. I am working to find one that doesn't. So if I do I will try and make sure to come back and share it!

I hope this helps!


----------



## Nuffa (Sep 12, 2014)

very stupid question:What exactly are digestive enzymes?


----------



## balancedgrub (Jul 13, 2014)

There are no antidepressant drugs that are good for you and that will aid your digestion. Antidepressants play with the chemicals in your body to alleviate one problem for another. I would strongly advise against them!

I have suffered with chronic constipation my whole life to and there are times when it's so hard to manage, unfortunately I was suisidle at the age of 17. But chose against more unwanted chemicals in my body. Instead I chose exercise, healthy eating, good friends to listen and will power to pull me through. I won't lie, it was a rough road but life is what you make it. I wanted to make it a positive one. I always find antidepressants are already at the stage of giving up and won't help you long term.

*Serotonin* is the major player in happy brain function, if you need a little extra help in the initial stages of pulling yourself out of your depression try *5-HTP**,* as it is a natural extract.

About *90% of serotonin (the happy hormone) is made in the gut, *if your gut is not working properly or is slow the same will happen to you; feel down and fed up. This is what has happens to me. This is a really good article too: *How the Gut's "Second Brain" Influences Mood and Well-Being*

Right now I'm on Resolor for my Slow, sluggish bowel, because I don't produce serotonin (I think you can't get it in the states yet). This has been a wonder drug for me as it mimics serotonin in the body and only uses what the body needs and no more.

My advice to you: Get your bowel on track by eating healthy (try a low FODMAP diet, that has helped me majorly), drink at least 2 liters of water a day, exercise regularly; even if it's just a walk, find someone you can talk to like a friend and try 5-HTP get you started. Always tell your doc if your going to change your diet 

You can read about my journey and find recipes to aid constipation here and what has helped for me may help you. www.balancedgrub.com

I hope that helps you & stay healthy!

Kate


----------

