# Advice needed - Which AD for these symptoms? (Mostly Spasms)



## 20840 (Dec 9, 2005)

Hi All,Well I've been searching these forums for the past week, looking for the best AD for my symptoms, which are:IBS-DBowel Spasms.. predominately when I wake up, which will last for an hour or so.I have been a long time user of immodium, however this does not get rid of my morning spasms, which have plagued me for ~ 7 years now and I've had enough.My first preference is Mirtazapine (Remeron) as it has these benefits:- Doesn't effect sexual drive- Decreases Serotonin levels in the bowel, hence can prevent contractions.- Non addictive- Good for Anxiety/Sleep (Have had insomnia, on and off, for the last 4 months).- Constipates (im Diaherrea prone)- Contributes to weight gain (I am on the skinny side due to being IBS-D).Elavil is the other AD I'm looking at. How does this compare to Remeron?Am I on the right track by having this AD at the top of my list? I'm chasing some advice from anyone out there who especially had morning spasms and has successfully gotten rid of them with a specific AD.Many thanks, Lindsay


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## Kathleen M. (Nov 16, 1999)

Elavil is pretty similar.There are some sex drive issues reported, but it tends to be rarer with the tricyclics than with SSRI's.Also with the tricyclics you usually are taking them at much lower doses than for depression so the side effects are less than they otherwise would be.You may have to try a couple of ones before you find the one that works for you.K.


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## tltrull (Nov 12, 2005)

Try the Elavil, it is good for sleep, has put 30lbs on my boney butt(I was 96lbs 5'2"), cramping has been less frequent and less painful. I have actually had more sex drive! I was able to cut my Lotronex dose in half and still control the D. I started at 25mg about a year ago, and am up to 75mg now...the weight went up more when the dose got higher. I gained it all within the 1st 5 months and havent added any new weight since.I may have gained a little more than I wanted, but am willing to deal with it since it helps.Unless you dont eat much because it causes D, it shouldnt affect your weight. All the nurtients from your food is absorbed in the small intestine which is not affected by IBS. Ibs can however cause dehydration because the colon is where you absorb all of your water.Absorb too much you are constipated, not enough you get D.


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## 20840 (Dec 9, 2005)

Kathleen: thanks for the info..tltrull: When you started at 25mg, did you take it before going to bed? How long was it until the daytime drowsiness subsided?


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## 20840 (Dec 9, 2005)

Have just started on 10mg a night of Endep (Amitriptyline), was looking for a slow release capsule but unfortuneatly we don't have this form in Australia.I'll post some updates here- some people may find it usefulay 1: Took the tablet at 9:30pm, went to sleep around 11ish. Woke up feeling mildly groggy, this passed around 30mins later. Mild spasms/pain on wakeup, didn't last long though. Slightly groggy feeling during the day, but a better feeling than getting no sleep!Effects of the drug seemed to get out of the bloodstream around 4-5pm as tension in the bowel could be felt as it was awakening.Day 2: Took the tablet at 9:45pm, went to bed at 11:00pm, fell asleep quite quickly. Woke up at 7:00am with mild spasms that lasted about 15mins, bowels has remained tense throughout the morning (compared to day 1 where it was relaxed). Have not felt as sleepy as Day 1, feel quite awake actually.Early days yet but I can see myself going up to 20mg or having 10mg at night, then 5mg at lunchtime.Dry mouth has not been an issue. This is probably because I use a toothpaste and mouthwash which target dry mouth.


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## tltrull (Nov 12, 2005)

The funny thing is, I never really had any daytime drowsiness. I still have trouble sleeping if you can believe that! I think at my next visit I may need to go up another dose.Everyone I talk to has gotten sleepy....I guess I am just an oddball.


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## 14486 (Mar 20, 2007)

I'm looking for something else too. I just went off Pamelar (noritriptyline - I don't know how to spell it). It made me more constipated, did not improve my sleep, made me groggy and dizzy, did not take away any depression and only slightly lessened my stomach pain. I have tried almost every SSRI plus Remeron and amitryptiline. I am not taking anything right now and my stomach hurts all day long. After I eat even the slightest bit I have excruciating pain where I need to lie down for an hour. It feels like trapped gas, because when I start to release it the pains subside a bit. I need something for anxiety and IBS that doesn't slow my system down too much, helps me sleep at night, and helps with stomach pain. Any ideas?


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## 20840 (Dec 9, 2005)

Been a while since I've replied to this thread, was being patient and waiting for longer before posting.When I hit Day 16 I found that my morning pain was very close to gone, in fact the last three days (19 days since the first dose) I can say that the spasm pain has GONE. I suspect that the bowels are still spasm a bit in the mornings, however my pain threshold has risen and I am none the wiser.Still waiting for the constipating effect to kick in (still have loose stools) but I suspect that it won't until I go up to 20mg. The tiredness during the day has lessened considerably which is great.


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