# What are the advantages of SSRI's?



## Lookin'foraLife (Jan 2, 2009)

PLEASE can anyone explain to me what advantage antidepressants have over other meds that affect the nerves in the gut such as narcotics, xanax, medical marijuana? All are addictive, have side effects, can be potentially dangerous.However, antidepressants must be taken everyday whereas the other meds can be taken on a "need to take" basis.So what advantage have antidepressants for IBS(no anxiety, no depression) that my doctor will only prescribe them?


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## Kathleen M. (Nov 16, 1999)

Narcotics over time sensitize the gut nerves in some people making things many many times more painful than they would otherwise be. They are also seriously addictive and can make some people way too loopy to function.Drugs like Xanax are also addictive and can make you way too loopy to function.95% of the serotonin (that SSRI's and other antidepressants work on) is in the nerves of the gut. So it is expected that drugs that effect serotonin may have effect in the gut. They also usually don't make it so you can't drive or work. Some people can find a dose of xanax or narcotics where they are functional, but usually not when on an as needed basis, that is more with regular use.FWIW tricyclics are more commonly used for pain in IBS and other conditions than SSRI's, but both can be used.While antidepressants can have side effects when you go off of them it is not the exact same thing as the chronically escalating addictive nature of tranquilizers or narcotics. You don't find people trying to find ways to get even higher, or need more and more to get the same high from their SSRIs which addicts do with the other meds.Most of the drugs designed specifically to treat IBS effect one of the serotonin receptors in the gut and they find some differences in serotonin measures in IBSers when compared to normal controls. So it isn't out of the box to think effecting serotonin may be part of the picture.


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## Lookin'foraLife (Jan 2, 2009)

Thanks for that very comprehensive and convincing answer. Out of curiosity: are IBSers considered to have too much or too little serotonin to begin with?


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## Kathleen M. (Nov 16, 1999)

It isn't quite that simple. I think it can sometimes be either way depending on the problem. Sometimes it is too much in the space between specific nerves rather than overall too much or too little.


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## Guest (Apr 23, 2009)

Hi there - for what its worth, I'm on long-term anti-d's for depression - so, I probably take a higher dose than any you'd be prescribed for your problems. However, I think its fair to say, these are not smarties - you may have some "weaning on" problems - even at lower doseages I'm assuming; dizziness, lightheadedness, possible tingling in your hands and feet, disorientation - you may not - your GP can advice you on this. I'm not trying to scare you - you might be absolutely fine - I suppose you need to weigh up any advantages which might be considerable against this - you may also notice changes in your weight.I've been on 30mg mitrazapene for over 3 years and apart from putting on weight - I'm symptom-free and leading a busy and full life.Good luckSue


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## Cherrie (Sep 1, 2006)

Lookin said:


> Thanks for that very comprehensive and convincing answer. Out of curiosity: are IBSers considered to have too much or too little serotonin to begin with?


Hi I agree, it's usually not how much of serotonin that one has in one's body (brain/gut), but whether there is an imbalance between how much is transmitted to and fro the receptor and the sender neurons. There are these two types of neurons -- one sends serotonin to another -- if the receptor neuron receives more than it should, then there is a serotonin imbalance. The SSRI (Selective serotonin reuptake inhibitor) or SNRI's (Serotonin-norepinephrine reuptake inhibitor), as their names suggest, help the receptor neuron to kick some of the serotonin back to the sender neuron instead of absorbing them all. So, this way the sender can send the serotonin back again and so forth. And so in this way, part of the serotonin keeps in between and eventually if the med is the one that works for a particular individual, the balance is re-achieved.


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## cherrypie09 (Jan 20, 2009)

HiI am already on Mirtazapine 30mg a day for anxiety, and now the Gastric specialist has put me on 20mg Noratriptyline as well, but for the IBS, he says it can help with it and it is slightly better than amitriptyline for IBS, which i tried years ago with no effect,(this was for the ibs). I have only had one dose so far, he said they were ok to take with the Mirtazapine, but i feel a little sick and spaced this morning. I hope they really are ok to mix, he must know hes a doctor right. ?


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## Lookin'foraLife (Jan 2, 2009)

Thanks to all for your replies and explanations. They were very helpful. I'm still reluctant to jump into the deep SSRI waters since I'm not convinced my problem lies with gut nerves and such. If I take a Xanax trial and it helps me would that be an indicator my problem lies with the gut-brain connection? If so, maybe I'll beg the doctors for some Xanax to begin with before commiting to the antidepressants? Good/bad idea?Hi cherrypie, you're probably experiencing the side effects of the antidepressant, it's supposed to get better with time. Let us know how it continues to affect you. Good luck! I may be joining you soon....


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## knitty (Jan 18, 2010)

Others have covered the pros/cons of different meds, but I can tell you my experience with SSRIs. I went on Paxil for plain old anxiety, and found that it totally helped my anxiety and IBS-D. Nice, huh? Well there were side effects, too. I gained 50 lbs over 3 years and began feeling totally unmotivated to get anything done. I've been off the Paxil for 6 months, have lost 20 lbs, but the IBS and anxiety have returned. Paxil is considered among the worst for weight gain (wish I knew that when I was first prescribed it!) and weird withdrawal symptoms (plan ahead to taper off slowly). So please be an informed consumer if you choose an SSRI, and know the difference between each type, they vary widely. Overall they can be quite effective but really get into your system in some ways you might not appreciate later.


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