# IBS-C cured (and caused) by Risperdal



## ILYA (Feb 22, 2010)

In 2003 I discontinued the anti-psychotic drug Risperdal. A month later I developed severe, classic IBS-C, and suffered with the condition for over six years. Last year I began taking Risperdal again, and within a few months the symptoms of IBS completely vanished. Bowel movements were regular and complete, there was no more intense, incapacitating rectal pain. My life returned to exactly how it had been for the first twenty-three years of my life, before I developed IBS. The illness was cured and I was once again a "normal" person who had the capacity for work and social relationships.Now, the catch is that Risperdal entails undesirable side-effects, like cognitive and emotional blunting. There is also risk of more severe neurological effects developing. For these reasons I'd love to be off the drug. Precisely when I lower the dose from 1.0mg to 0.75mg, however, the symptoms of IBS begin to re-appear. In the name of finding a different drug that, while also curing IBS, would not have the side-effects of an anti-psychotic, I'm curious as to the pharmacological role of serotonin in IBS. According to Wikipedia, Risperdal"belongs to a class of antipsychotic drugs known as atypical antipsychotics that have more pronounced serotonin *antagonism* than dopamine antagonism [...] It has actions at several 5-HT (serotonin) receptor subtypes. These are 5-HT2C, linked to weight gain, 5-HT2A, linked to its antipsychotic action". I'm curious in particular about the fact that my experience seems to be in direct contradiction with the paradigm according to which IBS is usually thought about and treated. Typically, serotonin agonists, not antagonists, are utilized in the treatment of IBS-C. Zelnorm, for example, is a serotonin agonist. Although I'm not sure about this, I believe all SSRIS are serotonin agonists as well. On the other hand, drugs used for IBS-D, such as Lotronex, are considered serotonin antagonists. Thus I cannot figure out why a serotonin antagonist like Risperdal would cure my IBS-C, while serotonin agonists like Zelnorm and SSRIs did nothing for me. Although these questions are very difficult and for the most part far beyond me, perhaps there is someone out there who can help me make sense of this apparent contradiction, as well as suggest some pharmacological possibilities.My wish is also to simply let people know that I did find a cure; something which for six years seemed to be an impossibility.


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## Kathleen M. (Nov 16, 1999)

It isn't just agonist/antagonist but which of the serotonin receptors the drugs effect as well.I do not know which receptor your drug actually works on. Zelnom may effect receptors in a different way than Lotronex but it also effects the 4th one of the serotonin receptors and Lotronex effects the 3rd on. SSRI's mostly effect yet another one of the serotonin receptors.Additionally there are idiosyncratic reactions. SSRI's may tend to cause diarrhea more than constiaption, but they also cause constipation for some people in clinical trials. It isn't all one or all the other. There is some of both for most of the psychiatric drugs.Off to look yours up and see if I see anything that makes sense.From the clinical trial data on rxlist.com looks like it causes diarrhea a bit more often than it causes constipation (like 8% vs 6%)


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## ILYA (Feb 22, 2010)

Wikipedia says Risperdal has actions at 5-HT2C and 5-HT2A receptors....I don't think the drug cured my IBS-C simply by inducing a diarrhea side-effect. I experienced no diarrhea-like symptoms. What I did experience was a complete normalization of peristalsis and evacuation, as well as an almost total reduction of that tormenting rectal sensation which was a primary component of my IBS-C. In other words, in my opinion Risperdal did not work by superficially countering constipation with diarrhea. Rather, it seemed somehow to target the essence of IBS-C pathology. Along what pathways it did so is the massive mystery I'm now in the process of trying to solve.


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## Kathleen M. (Nov 16, 1999)

The antidepressants also work besides by changing movement through the GI tract (which is what Lotronex and Zelnorm do to ease diarrhea and constipation) they can also effect the excessive sensing of the GI tract which leads to it over reacting to things or blocking inappropriate pain. Zelnorm and Lotronex do both of those.So even SSRI's tend to cause diarrhea more than constipation they also effect pain and other sensory issues. I don't know that your drug must do something completely and totally different than every other serotonin effecting drug.A lot of people take Zelnorm, Lotronex, SSRIs and every other kind of antidepressant to deal with pain and rectal hypersensitivity that happen with IBS no matter what kind of stooling issues you have. However one that tends to loosen stools is better for those that tend to be constipated and those that tend to constipate are better for those with diarreha but all of them seem to work on rectal hypersensitivity issues. I would suspect your drug does too. Doesn't seem logical it can't be doing that for some people when every last other drug effecting serotonin seems to help with pain and rectal hypersensitivity issues for other people.Usually if you add a drug that tends to cause a bit of diarrhea to someone that is constantly constipated they go to normal (assuming the dose is right) not go all the way to watery diarrhea.


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## ILYA (Feb 22, 2010)

> I don't know that your drug must do something completely and totally different than every other serotonin effecting drug.


Risperdal did do something different. Unlike Zelnorm and the several SSRIs with which I experimented over the years, it completely eliminated IBS. Perhaps other sufferers have found relief in SSRIs or Zelnorm. Reading this forum, however, I've come across little evidence of anyone finding total satisfaction with those drugs. I simply mean to bring attention to the fact that the atypical antipsychotic Risperdal, which apparently has antagonistic actions at 5-HT2C and 5-HT2A receptors, made my IBS-C disappear.


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## Kathleen M. (Nov 16, 1999)

I don't know with the side effect profile if they will prescribe it for people who don't need it for mental health reasons. Usually the more severe the mental illness the more risk they will take with side effects. Not sure how it overall compares to the antidepressants for risk in healthy people.I got really good relief of the rectal hypersensitivity and pain (better when the IBS was milder than when it was severe, but it was enough to keep me functional even if I wasn't 100%) with Buspar which is pretty low risk for non-anxious people to take. Other than a bit of light-headeness right after the dose most people don't have much in the way of side effects and I could counter act the light-headedness that was only for a short while if I made sure I ate before I took it in the morning.However I am glad to hear it is working well for you. I don't know if it caused the IBS-C or you got it while you were on the drug from something else and it was treating those symptoms so they didn't show up until after it was discontinued.


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## ILYA (Feb 22, 2010)

I think atypical antipsychotics generally affect the body and mind much more profoundly than most antidepressants. This, however, doesn't stop doctors from prescribing them unrestrainedly. In current mental health practice you don't need a schizophrenia diagnosis in order to be considered a legitimate candidate for these drugs. An anxiety disorder or refractory depression will suffice. This leads me to believe that the atypicals could easily become standard off-label treatments for IBS. Personally, the rewards of living free of IBS outweigh the risks and side-effects associated with the Risperdal; although only by the slimmest of margins.


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## Borrellifan (May 5, 2009)

ILYA said:


> I think atypical antipsychotics generally affect the body and mind much more profoundly than most antidepressants. This, however, doesn't stop doctors from prescribing them unrestrainedly. In current mental health practice you don't need a schizophrenia diagnosis in order to be considered a legitimate candidate for these drugs. An anxiety disorder or refractory depression will suffice. This leads me to believe that the atypicals could easily become standard off-label treatments for IBS. Personally, *the rewards of living free of IBS outweigh the risks and side-effects associated with the Risperdal; although only by the slimmest of margins.*


Not sure I can agree with you there. I tried taking a SSRI to treat my IBS and the side effects were god awful to deal with. I'd rather feel normal (state of mind) and have IBS then be all looped up on these drugs. There are many people on these forums with alot of problems and they should be on these things but the rest of us just want to treat our IBS and not our heads.I don't agree with the way these meds are being used to treat IBS. I know for a fact that when i took those SSRI's it may have slightly helped my IBS but my body and head where saying "what the heck are you taking these for" and by no means did it cure me. I think it gives IBS patients a bad rep and gives doctors a excuse to simply say they're all a bunch of whacko's that have psycho problem's.Not for me but to each his own.


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## ILYA (Feb 22, 2010)

I see what you're saying. It would be great if you discovered a cure outside of the serotoninergic paradigm, since then psychotropic medications and the accompanying stigma could be altogether eliminated from the theory and practice of IBS treatment. Until that happens, though, I'll just have to put up with being cured by this 5-HT2C and 5-HT2A receptor antagonist. On that note, anyone have any thoughts on the drug Mirtazapine in this context?


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## TummyDepressed (Feb 2, 2010)

Could this all be linked to physiological factors?Is it possible Ilya that you have something like Pevlic Floor Dysfunction.I have been diagnosed with this. My muscles dont co-ordinate properly... for some reason my brain 'turned off' my ability to pass stools effectively. Perhaps the anti-depressant/medication counteracts this switch in the brain.....??


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## Kathleen M. (Nov 16, 1999)

There are serotonin receptors all over the body and most of the serotonin in the nervous system is in the gut, not the brain.Because serotonin effecting drugs are used a lot in psychiatry a lot of people think all the serotonin is in the brain, but the body uses it for a lot of things, and a lot of those are in the gut nerves. It takes a lot of nerves to keep the GI tract running properly so that is why a lot of the serotonin in the body is in the gut.They usually think the serotonin effecting drugs both specifically for IBS and any antidepressants, etc used are directly effecting the gut nerves.


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## ILYA (Feb 22, 2010)

It may sound counter-intuitive, but I'm highly suspicious Remeron could also be a cure for IBS-C. Remeron is the only antidepressant that, like the antipsychotic Risperdal, is an antagonist at 5-HT2C and 5-HT2A receptors. Now I need to find a doctor who will write me a prescription so I can conduct an experiment.


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## Kathleen M. (Nov 16, 1999)

Remoren usually is used for IBS-D not IBS-C.It is similar chemically to the drug Lotronex. When Lotronex was pulled this drug and Zofran which is an anti-nausea drug were common things people tried.In studies it is more likely to cause constipation as a side effect then diarrhea.


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## idkwia (Feb 26, 2009)

ILYA - this is very interesting as I have just been prescribed an atypical antipsychotic. The doctor explained to me that whilst I am not depressed or anxious the drug is a tranquliser that might just calm everything down and make the digestive system start working normally again. He also prescribed the anti-depressant Mirtazapine in a low to medium dose with the same thinking in mind.I should say that I am not a 'typical' IBS patient as I am not constipated and do not have diarrhea. I have almost constant nausea and stomach discomfort.In reading your story may I ask how long you have were on Risperdal for? And is it not possible that it didn't actually give you IBS but that it either just started anyway due to coincidence or that you got it when you were on Risperdal but it was just kept at bay by that drug? I also think it is fair to say that the pain you describe in your rectal area doesn't sound like typical IBS and as one other user mentioned could be a pelvic floor problem.Thanks for posting. I look forward to your answers.


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## ILYA (Feb 22, 2010)

> The doctor explained to me that whilst I am not depressed or anxious the drug is a tranquliser that might just calm everything down and make the digestive system start working normally again. He also prescribed the anti-depressant Mirtazapine in a low to medium dose with the same thinking in mind.


I really think these drugs, atypicals and the novel antidepressant Mirtazapine, do something far more specific than just "calm everything down" with a general tranquilizing effect. I think it is their particular serotoninergic action. With Risperdal and Mirtazapine/Remeron, this is an antagonistic action at 5-HT2c and 5-HT2a receptors. I don't know how other atypicals, Zyprexa or Seroquel for instance, affect serotonin. I do believe Risperdal has a much more pronounced serotoninergic effect than the other atypicals. I find comparing our situations tricky, however, since your issue is not with IBS-C but nausea and stomach discomfort. I do know that all literature suggests Mirtazapine is excellent for nausea. It is a serotonin antagonist, and other drugs of this class are apparently used to treat nausea from chemotherapy (someone correct me if I'm wrong) The drug Lotronex, used to treat IBS-D, is also a drug of this class. Now, what I'm wrestling with right now is that the atypical Risperdal, another serotonin agonist like Mirtazapine and Lotronex, has at the precise dose of 1.0mg cured my IBS-C. At the risk of making a grandiose statement, I'm seriously wondering if IBS scientific inquiry has perhaps overlooked serotonin antagonists as a treatment for IBS-C, while focusing too much attention on serotonin agonists like Zelnorm and SSRI antidepressants. Of course, this part doesn't really apply to you, idkwia, since you don't have IBS-C. Anyway, I hope what I'm saying here is at least partly intelligible.


> In reading your story may I ask how long you have were on Risperdal for? And is it not possible that it didn't actually give you IBS but that it either just started anyway due to coincidence or that you got it when you were on Risperdal but it was just kept at bay by that drug?


As far as my experience with Risperdal, I was on it the first time for two years, from 2001 to 2003. While it could have been a coincidence, my suspicion is still that my IBS-C developed as a result of the drug powerfully messing around with HT2c and 5-HT2a receptors. Along these pathways, I think I became physiologically dependent on the drug for normal bowel function. Thus, when I discontinued the med the IBS-C emerged. After many years of suffering, I went back on Risperdal just over a year ago and the symptoms vanished. Now, of course, the goal is to find out if Mirtazapine, which has almost exactly the serotoninergic profile of Risperdal, can cure the IBS-C, thus allowing me to be free of atypical antipsychotics. (I don't want to worry you idkwia, since they aren't the worst thing in world in terms of side-effects. However, if you can find a way to get by and achieve what you want in life without antipsychotics, that's probably the way to go)


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## ILYA (Feb 22, 2010)

hmmm....Trazodone is also a 5-HT2c and 5-HT2a antagonist, with possibly fewer side-effects than Remeron. Bring on the trazodone then...


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## idkwia (Feb 26, 2009)

ILYA - thanks a lot for your reply. I am going to see what happens when I increase the Mirtazapine to 30mg from 15mg and then think about the atypical psychotic which is Olanzapine 2.5mg per day.With regard to my comment of these drugs calming averything down, this was just the doctors way of making things simple for me to understand I am sure. But overall the gut and the brain may be overacting to normal digestion and so his explanation makes sense and worth a try.


ILYA said:


> hmmm....Trazodone is also a 5-HT2c and 5-HT2a antagonist, with possibly fewer side-effects than Remeron. Bring on the trazodone then...


I should tell you that I didn't experience any side effects with Mirtazapine. In addition I have just read that one of the side effects of Trazodone is constipation.Either way, good luck and let us know how it goes.


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## ILYA (Feb 22, 2010)

> In addition I have just read that one of the side effects of Trazodone is constipation.


Constipation is also a listed side-effect of Risperdal. Furthermore I have read reports of people experiencing terrible constipation on Risperdal. Yet Risperdal cures my IBS-C. At any rate, this pharmacology, meaning the significance and function of the many 5-HT receptors (http://en.wikipedia.org/wiki/5-HT_receptor) in relation to agonist or antagonist drugs, is very, very complicated business. From a layperson's perspective theorizing as I'm trying to do is frustrating and probably useless. For instance, I deduce from my experience with Risperdal that all 5-HT2c and 5-HT2a antagonists could cure IBS-C; and then I discover that Elavil, a drug which I know from experience does nothing for my IBS, is also a 5-HT2c and 5-HT2a antagonist. So my Remeron/Trazodone hypothesis has taken a bit of a hit. Personal experimentation is the only way to go. Once I resolve my currently disastrous doctor situation, I will definitely let people know what I find out regarding how Remeron and Tradozone compare to Risperdal in terms of curing IBS-C.


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## annie7 (Aug 16, 2002)

this has been a fascinating thread. thanks for starting it, ilya.i have ibs-c. i take 75 mg tradozone nightly for my insomnia--have been taking it for at least five years. at first i was concerned about taking it because constipation is listed as one of the side effects but it hasn't seemed to have made my c worse. it definitely hasn't helped my c either--but i'm taking a fairly low dosage. it does help me sleep.


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## ILYA (Feb 22, 2010)

ok...I just stumbled upon some facts that seem to support an entirely different theory of Risperdal's serotonergic role in causing and curing my IBS-C.As well as a 5-HT2c and 5-HT2a antagonist, Risperdal is a 5-HT7 "inactivating antagonist" (http://molpharm.aspetjournals.org/content/70/4/1264) (http://en.wikipedia.org/wiki/5-HT7). While 5-HT2c and 5-HT2a receptors have considerable roles in GI functioning, I have found a study (http://www.cmj.org/periodical/PaperList.asp?id=LW2007123398611009282) which speculates that 5-HT7 receptors also play a very important, perhaps essential part in the pathology of IBS:"5-HT7R, a G-protein-coupling receptor, has been recently shown to have at least 4 subtypes1 and plays a role in regulating smooth muscle relaxation in the gastrointestinal and peripheral nociceptive pathways. 5-HT7R may be involved in the pathological mechanisms of gastrointestinal dyskinesia, abdominal pain and visceral paresthesia in IBS"Here is one conclusion of the study: "This finding further indicates that the 5-HT7 receptor's increasing expression in the gut closely correlates with mechanisms such as gastrointestinal dyskinesis of IBS-C. Further studies on the 5-HT7 receptor's role in IBS patients would provide new insights into the pathogenesis of the disease and 5-HT7 receptor ligands may offer innovative opportunities for the pharmacological treatment of functional bowel disorders such as IBS."Thus, Risperdal is an irreversible inactivating antagonist at a receptor potentially central to all the worst symptoms of IBS. Very interesting; although I don't like the sound of this at all. Risperdal is the only anti-psychotic, and one of only a handful of other medications, which possesses this strange property of being an irreversible inactivating antagonist of the 5-HT7 receptor. So, there's a chance I could be stuck on it the rest of my life. Nightmares like this are what happens when companies market and doctors prescribe drugs the pharmacological mechanisms of which are almost totally unknown. At any rate, the point to be found in all this for other IBS sufferers could be that 5-HT7 is where it's at when it comes to IBS. I realize, again, that these issues are far too complicated for this board. At least I think they are. Maybe someone is out there who has some insight. I just feel compelled to post because I believe my apparently unique experience with Risperdal is a potentially fertile source of speculation about IBS. That speculation would of course need to be pursued by a team of pharmacologists and IBS specialists. Here my primary hope is to simply stumble upon some ideas regarding already approved medications that would mimic the action of Risperdal, thus introducing other options for curing my IBS, and possibly that of others as well.


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## idkwia (Feb 26, 2009)

Ilya - in one of your earlier posts you stated "an almost total reduction of that tormenting rectal sensation which was a primary component of my IBS-C". Can you describe the rectal sensation in more detail please as I am trying to draw comparisons with my own symptoms.You have also said that you were going to find a doctor to prescribe you with Mirtazapine/Remeron as you believe they act in a similar way to Risperdal, have you done that?


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## ILYA (Feb 22, 2010)

The tormenting rectal sensation is an intense pressure originating just below the tailbone and radiating throughout the entire body, to the point where it even causes problems with physical coordination and speech. Pardon the graphic description, but this pressure definitively feels like it is the result of an excessive accumulation of fecal matter in the rectum. I believe my IBS consisted of both this excessive accumulation, due to a very real inability to have full bowel movements, *and* an extremely heightened sensitivity to these rectal contents. My psychotropic drugs positively affect both problems: They allow for full bowel movements regularly emptying the rectum, and they reduce sensation. For example, I was for awhile recently taking tylenol 3 with codeine. This drug would sometimes prevent me from having any bowel movement whatsoever for up to three days. Nevertheless, since I am on the Risperdal, I did not experience any tormenting sensation related to what was certainly an over-accumulation of content. I have just recently begun seeing a new psychiatrist and will ask for a Remeron prescription when I feel the timing is right. The discoveries detailed in my previous post however would seem to contradict the theory that Remeron will act like Risperdal.


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## idkwia (Feb 26, 2009)

ILYA said:


> The tormenting rectal sensation is an intense pressure originating just below the tailbone and radiating throughout the entire body, to the point where it even causes problems with physical coordination and speech. Pardon the graphic description, but this pressure definitively feels like it is the result of an excessive accumulation of fecal matter in the rectum. I believe my IBS consisted of both this excessive accumulation, due to a very real inability to have full bowel movements, *and* an extremely heightened sensitivity to these rectal contents. My psychotropic drugs positively affect both problems: They allow for full bowel movements regularly emptying the rectum, and they reduce sensation. For example, I was for awhile recently taking tylenol 3 with codeine. This drug would sometimes prevent me from having any bowel movement whatsoever for up to three days. Nevertheless, since I am on the Risperdal, I did not experience any tormenting sensation related to what was certainly an over-accumulation of content. I have just recently begun seeing a new psychiatrist and will ask for a Remeron prescription when I feel the timing is right. The discoveries detailed in my previous post however would seem to contradict the theory that Remeron will act like Risperdal.


Ilya - Ok, interesting answer. This is quite different to my sensation which is that I have the feeling that faeces are stuck for hours on end in my rectum. However, I do evacuate my bowels 1 to 3 times a day.Why don't you ask your psychiatrist for a drug with a similar action to Risperdal but without the other effects that you don't like?I have just started taking Olanzapine which is also an atypical antipsychotic. Have had no side effects at all. Be interesting to see what is does for my symptoms. Would this be a possibility for you perhaps?By the way have you had the possibility of a tethered spinal chord dismissed?


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## ILYA (Feb 22, 2010)

I've never heard of a tethered spinal cord. I'll look into it. As far as rectal sensation, it wouldn't be inaccurate to describe what I experienced as "the feeling that faeces are stuck for hours on end in my rectum". This seems like what I mean by a feeling of over-accumulation. Are you still on Remeron idkwia? If so how is the experience?Olanzapine wouldn't be an option because I imagine it would entail the same unwanted side-effects as Risperdal, such as ruining my ability to enjoy literature and sex.Let's just say my psychiatrist has her limitations. I don't think she would know the answer to the question of what drugs would mimic Risperdal since she's very old school, not really up to date on the latest pharmacological science. So it's up to me, with Wikipedia and my junior high knowledge of chemistry, to find drugs with similar properties to Risperdal in hopes that she'll prescribe them. I would give anything though to find a cutting edge psycho-GI-pharmacologist who could address my many concerns.


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## ILYA (Feb 22, 2010)

So Risperdal is an antagonist at 5HT-2a, 5HT-2c and 5HT-7. It is also a D2 (dopamine) antagonist. Well, lo and behold: Gastroprokinetic agents "may increase acetylcholine concentrations by antagonizing the D2 receptor which inhibits acetylcholine release . . . Higher acetylcholine levels increase gastrointestinal peristalsis and further increase pressure on the lower esophageal sphincter, thereby stimulating gastrointestinal motility, accelerating gastric emptying, and improving gastro-duodenal coordination" (http://en.wikipedia.org/wiki/Gastroprokinetic_agent)So now it seems the whole of cast of characters is potentially involved: Serotonin, Dopamine, Acetylcholine.....I'm officially totally lost and ready to give up on this train of thought.


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## idkwia (Feb 26, 2009)

Ilya - Remeron/Mirtazapine has enabled me to not have any 'episodes' at night and I had no side effects whatsoever.I can see why you are ready to give up your train of thought as it is very complicated. I suspect that even the people who should know don't actually know everything. Maybe you should try to find a pharmacologist who is an expert in these type of drugs and write to him/her. If you do, please let us know what you come up with.In the meantime I just read this which you may find interesting:-*L-Tryptophan and P5P. <== Very Important. Emotions and mood swings, such as excitement, anxiety, and depression can have very negative effects on the body, including high blood pressure, high heart pulse rate, poor digestion, constipation, or diarrhea. The combination of these supplements is a major breakthrough in digestive health. It works by calming the digestive system, hormones, and all autoimmune diseases. The combination of NSI L-Tryptophan (an essential amino acid) and vitamin P5P (pyridoxal-5-phosphate, the active form of vitamin B6) promotes healing of the digestive system. P5P is needed to convert L-tryptophan to serotonin. The serotonin calms digestion and the immune system. Serotonin promotes sound sleep and can be the cure for insomnia, an awesome side benefit. Serotonin is a neurotransmitter involved in the regulation of mood. Adverse symptoms can include sleepiness and a tired, sluggish feeling. Take one 500mg L-tryptophan capsule and one 50mg P5P capsule twice a day with breakfast and dinner. Do not substitute 5-hydroxy-L-tryptophan (5-HTP) for the pure pharmaceutical L-tryptophan recommended here. The body does not react to them in the same way. Do not substitute vitamin B6 for the P5P. It is not the same. These two supplements may not be available at your local vitamin store. Click the links above to buy them via mail order on the Internet or telephone. Do not skip this important new alternative treatment for all autoimmune diseases.*


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## faze action (Aug 6, 2009)

idkwia said:


> Ilya - Remeron/Mirtazapine has enabled me to not have any 'episodes' at night and I had no side effects whatsoever.I can see why you are ready to give up your train of thought as it is very complicated. I suspect that even the people who should know don't actually know everything. Maybe you should try to find a pharmacologist who is an expert in these type of drugs and write to him/her. If you do, please let us know what you come up with.In the meantime I just read this which you may find interesting:-*L-Tryptophan and P5P. <== Very Important. Emotions and mood swings, such as excitement, anxiety, and depression can have very negative effects on the body, including high blood pressure, high heart pulse rate, poor digestion, constipation, or diarrhea. The combination of these supplements is a major breakthrough in digestive health. It works by calming the digestive system, hormones, and all autoimmune diseases. The combination of NSI L-Tryptophan (an essential amino acid) and vitamin P5P (pyridoxal-5-phosphate, the active form of vitamin B6) promotes healing of the digestive system. P5P is needed to convert L-tryptophan to serotonin. The serotonin calms digestion and the immune system. Serotonin promotes sound sleep and can be the cure for insomnia, an awesome side benefit. Serotonin is a neurotransmitter involved in the regulation of mood. Adverse symptoms can include sleepiness and a tired, sluggish feeling. Take one 500mg L-tryptophan capsule and one 50mg P5P capsule twice a day with breakfast and dinner. Do not substitute 5-hydroxy-L-tryptophan (5-HTP) for the pure pharmaceutical L-tryptophan recommended here. The body does not react to them in the same way. Do not substitute vitamin B6 for the P5P. It is not the same. These two supplements may not be available at your local vitamin store. Click the links above to buy them via mail order on the Internet or telephone. Do not skip this important new alternative treatment for all autoimmune diseases.*


That's interesting... I just googled L-Tryptophan and P5P. To be honest I'm a little skeptical about anything that claims to be a wonder drug/supplement, especially when the majority of the testimonials come from sites trying to push a product. This does sound very interesting though, especially because I also suffer from sleep maintenance insomnia as well as GI issues. If anyone has any experience taking the LT-P5P combo I'd love to hear about it.


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## faze action (Aug 6, 2009)

This is an interesting article; not sure if someone here linked ot it, or I may have googled it myself (brain is a little hazy due to not sleeping enough!):http://www.smart-drugs.net/ias-tryptophan-article.htm


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## annie7 (Aug 16, 2002)

yes that is an interesting article..seems familiar.i've had chronic insomnia since childhood--sleep onset and sleep maintenence combined. and it got a whole lot worse of course when i worked the midnight shift in the early 80's. so then i started taking l-tryptophan--tried various brands, strengths as well as taking with b-6. and it did help some but was unrealiable. i'd say l-trypt was effective about sixty percent of the time. then it was pulled from the us market due to (if i'm remembering this correctly) contamination issues.when i went on the day shift i still had insomnia and tried melatonin, various brands and strengths--didn't work and it made me extremely depressed--and also 5-htp which didn't work either. none of these supplements had any effect whatsoever on my constipation.but really i always feel it's worth it to think positive and try anything and everything. we're all so different in our body chemistry and how we react to meds. and in my case being on the night shift certainly didn't help. good luck if you decide to try it--hope it works for you! insomnia is no fun especially on top of digestive problems...and i think they each make the other worse..at least in my case.


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## ILYA (Feb 22, 2010)

I actually found the email address of a pharmacology student who is doing her Ph.D on how drugs like Risperidone affect serotonin. I'm awaiting a response; but from experience I know it's very rare that an academic or doctor will respond when you email them out of the blue. I also fear she may be hesitant to correspond because what I would be asking her could be construed as bordering on medical advice.Anyway, as far as OTC supplements involving serotonin, I have tried some in the past and, like Annie7, they did nothing for my IBS-C. I think their affect on serotonin is too generalized and possibly too weak, compared to the very specific and potent receptor bombardment carried out by prescription psychotropic drugs. It is not simply a matter of increasing serotonin levels . There are I don't how many different receptor types and subtypes of serotonin, and these nuances must be taken into account when looking for cures. Keep in mind that SSRIs did nothing for my constipation either; and I tend to believe that if OTC supplements do anything at all it is along the lines of SSRIs.I have a question Annie7. Have you ever tried Elavil/Amitriptyline for your IBS-C? I know it's typically used for IBS-D; but I'm finding and experiencing more and more evidence that it has potential with IBS-C. For example, although it is weaker, Elavil's action on serotonin is very similar to Risperdal: They are both antagonists at 5HT-2a, 5HT-2c and 5HT-7. Furthermore, it is also possible I have recently developed a dependence on Elavil for bowel function similar to that I have developed with Risperdal. When I lower my Elavil dose below 25mg, the rectal sensitivity insidiously creeps back into the picture. This is disastrous because Elavil cannot be combined with psychostimulants such as Ritalin; yet psychostimulants are the only thing that makes life on an antipsychotic bearable.Elavil is also a wonderful, slightly pleasurable sleep experience. In many ways, I prefer it to benzodiazepines for sleep issues.


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## annie7 (Aug 16, 2002)

ilya-yes i've been on elavil a couple times--varying doses. it made my c worse and it didn't seem to help at all with sleep either. in fact the second time i was on it i had some weird experiences with very sudden awakenings--the sitting-bolt-upright-in-bed sort of thing. that's why i went off it the second time. just another example of how people's experiences with meds can vary...everybody's different.i've tried a couple ssri's which didn't help my c or insomnia either plus the side effects were so troublesome i decided not to try any more for the time being.hope the pharm student answers your e-mail. thanks for all the info you've been posting--very interesting.


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## idkwia (Feb 26, 2009)

Faze Action - just a suggestion, why don't you start a new thread about L-Tryptophan and P5P, you might get some more insights?


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## ILYA (Feb 22, 2010)

Of course everyone is different and reacts to meds in different ways, especially with something as hard to pin down as IBS. It's just that usually when something happens to you these days, you can go online and immediately find thousands of others who have experienced the same thing. Yet searches for IBS and Risperdal turn up almost nothing, which remains a huge mystery to me. I simply can't be the only Risperdal user to have experienced this.Anyway, the despair experessed in my earlier post about dopamine (D2) antagonists has turned to joy. Surfing the web for purposes such as this definitely is a rollercoaster ride. It turns out that Domperidone (I don't think it's available in the US) is a D2 antagonist exactly like Risperdal and other anti-psychotics. The difference is, however, that Domperidone apparently does not enter the brain or, one study claimed, does not enter the central nervous system. At any rate, what this means is that it should have all the dopaminergic gastrointestinal effects of my anti-psychotic, without ANY anti-psychotic side effects such as cognitive blunting or fatigue.idkwia, I think it could be along these lines that you have been prescribed Olanzapine; especially because I think D2 antagonists address primarily "upper" GI symptoms such as nausea, heartburn and difficulty emptying the stomach. They are, however, also said to positively affect constipation and GI motility.The point for me is that there's hope once again that most or all of the gastrointestinal effects of Risperdal could be recreated using other, non-antipsychotic meds. The dopamine side of things could be covered by Domperidone while the serotonin side, a bit more problematic, could be covered along the lines of something like Remeron or Elavil.Anyway, I'm sure tomorrow I'll find some new info that will make things seem hopeless once again.


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## faze action (Aug 6, 2009)

idkwia said:


> Faze Action - just a suggestion, why don't you start a new thread about L-Tryptophan and P5P, you might get some more insights?


Done!


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## idkwia (Feb 26, 2009)

ILYA said:


> Of course everyone is different and reacts to meds in different ways, especially with something as hard to pin down as IBS. It's just that usually when something happens to you these days, you can go online and immediately find thousands of others who have experienced the same thing. Yet searches for IBS and Risperdal turn up almost nothing, which remains a huge mystery to me. I simply can't be the only Risperdal user to have experienced this.Anyway, the despair experessed in my earlier post about dopamine (D2) antagonists has turned to joy. Surfing the web for purposes such as this definitely is a rollercoaster ride. It turns out that Domperidone (I don't think it's available in the US) is a D2 antagonist exactly like Risperdal and other anti-psychotics. The difference is, however, that Domperidone apparently does not enter the brain or, one study claimed, does not enter the central nervous system. At any rate, what this means is that it should have all the dopaminergic gastrointestinal effects of my anti-psychotic, without ANY anti-psychotic side effects such as cognitive blunting or fatigue.idkwia, I think it could be along these lines that you have been prescribed Olanzapine; especially because I think D2 antagonists address primarily "upper" GI symptoms such as nausea, heartburn and difficulty emptying the stomach. They are, however, also said to positively affect constipation and GI motility.The point for me is that there's hope once again that most or all of the gastrointestinal effects of Risperdal could be recreated using other, non-antipsychotic meds. The dopamine side of things could be covered by Domperidone while the serotonin side, a bit more problematic, could be covered along the lines of something like Remeron or Elavil.Anyway, I'm sure tomorrow I'll find some new info that will make things seem hopeless once again.


Domperidone is freely available in the UK and no doubt other countries. I used it 4 times a day for a month but had no benefit although no side effects. However, that doesn't mean that it wouldn't work for you. It is basically an anti-emetic as well as improving the motility of the stomach. Maybe you should give it a try.


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