# Wondering which drug most appropriate



## NancyCat (Jul 16, 1999)

One of my major symptoms is increased sensitivity to pain/pressure, not alot of D not alot of C, on "good days" go alot. I read that antidepressants can help by acting on the nuron in your brain that perceives the pain/discomfort and am wondering which drug might do this. I have little confidence in the DR's I've seen so far, they prescribe what the drug companies are pushing this week and even fewer of them "get it" about IBS. Thanks in advance







Also after 20 years of fighting with my bowel on an almost daily basis in one way or another it is starting to get depressing


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## NancyCat (Jul 16, 1999)

Bump


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## JennyBean (Mar 23, 2002)

I don't have a good answer to your question because I don't know too much about all the different types of antidepressants, but I can tell you that I've been on a very low dose of paxil (5mg) for 2 weeks now, and the pain is not nearly as bad as it has been. For more than a year, I've pretty much had constant pain, but now, I don't have it all the time. Sometimes I can go a couple of days without any excruciating pain, and even when I get that, it doesn't last all day long anymore. I also have C, and my doc said paxil is good for C since D is one of the side effects I guess. It has been helping a little bit with that, too. I know that tricyclic antidepressants are better for D, but since you don't have the pooh problems that bad, I don't know which one would be right for you. All I can tell you is what I'm experiencing right now. Good luck!


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## mxwe (Apr 7, 2002)

I take Paxil and Wellbutrin-


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## metooo (Feb 26, 2002)

Anyone else taken Paxil and found it has helped with pain and constipation. I thought it can increase constipation, however I guess we all react differently.I'm wondering if I should start again on a low dose and maybe be more patient?! So far I haven't had much luck with SSRI's but am getting real despereate.Do you find it makes you real sleepy?


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## JennyBean (Mar 23, 2002)

The Paxil made me extremely tired for about the first week and a half or so. All I wanted to do was sleep, but now I feel normal. It just takes a couple weeks for your body to get used to the pill and the side effects will go away. However, I am planning on bumping it up to 10mg soon because I'm also dealing with an anxiety disorder and 5mg isn't doing much for it. So I'm gonna have to go through the bad side effects again, but it really seems worth it. It started helping with my pain right away, but it took a few weeks to really start regulating my poop. I still get constipated now, but it's a rarity. I notice when I'm constipated now, whereas before, I was just always constipated that I was pretty well used to feeling all stopped up!


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## slacker (Mar 23, 2002)

Since your bowel habits are neither C or D really, you'll probably just have to try some and see what happens, and if you tolerate the D or C they MAY give you. GP's usually don't know what they are doing but if you go to a shrink the good ones decide which anti-depressant(s) to try first based on your complaints, or what problems you have or they think you have along with the depression, i.e Anxiety disorders, Panic disorder, Bulimia, OCD, nausea, overweight, underweight, IBS-D, blah blah blah. People that have normal bowel habits that take them usually don't seem to have much of a problem either way, D or C, and if they do, its in the first few days-week or so or whatever. I'm not C or D either. I used to take Zoloft, 50mg which should give you D if anything, and it didn't mess me up either way, but I never took more than 50mg. 100mg-200mg is common. I don't remember if it helped pain or not...but it made me feel kinda goofy for a few hours several hours after I took it, nothing serious, and it pretty much went away in like a week. And I take Remeron now, cuz it blocks the brain receptor responsible for Nausea. It is also a very potent anti-histamine, so it should give constipation if anything. And at 45-60mg it slowed my motility down and gave me some incomplete evacuation but not constipation. At 7-15 this is minimal, the higher you go, the bigger the anti-histamine constipation effect... If Benadryl constipates you (probably not), this will too I guess. C people probably should avoid. It also blocks the brain receptor responsible for anxiety, insomnia, and sexual dysfunction. It makes me pretty dull, and lethargic and drowsy, more so in the morning. This is mostly a problem at doses under 30mg..30 is a good dose, it wont make you so drowsy during the day(you take it at night because it pretty much knocks you out). The anxiety block is quite effective, for me its too effective. I think thats why it kinda supresses my personality.7-22mg youll be kinda drowsy, 30 is good, 45-60 is annoying. Pain wise, I don't know that it helps pain a lot per se, but if part of your pain problem is from anxiety, then it will help that pain. Im too lazy to explain why less of it makes you MORE drowsy, but it does. The Tricyclics (the old school anti-depressants) are supposed to help pain, by messing with the way your brain perceives pain or something. Personally, I haven't tried any. I'm not sure what they do D or C wise. Good luck, really if all you have is depression and some pain, it probably is anyones guess which one you should try first. An anti-spasmodic, if you havent tried them, may or may not help your pain, and may or may not cause some C.


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## slacker (Mar 23, 2002)

Since your bowel habits are neither C or D really, you'll probably just have to try some and see what happens, and if you tolerate the D or C they MAY give you. GP's usually don't know what they are doing but if you go to a shrink the good ones decide which anti-depressant(s) to try first based on your complaints, or what problems you have or they think you have along with the depression, i.e Anxiety disorders, Panic disorder, Bulimia, OCD, nausea, overweight, underweight, IBS-D, blah blah blah. People that have normal bowel habits that take them usually don't seem to have much of a problem either way, D or C, and if they do, its in the first few days-week or so or whatever. I'm not C or D either. I used to take Zoloft, 50mg which should give you D if anything, and it didn't mess me up either way, but I never took more than 50mg. 100mg-200mg is common. I don't remember if it helped pain or not...but it made me feel kinda goofy for a few hours several hours after I took it, nothing serious, and it pretty much went away in like a week. And I take Remeron now, cuz it blocks the brain receptor responsible for Nausea. It is also a very potent anti-histamine, so it should give constipation if anything. And at 45-60mg it slowed my motility down and gave me some incomplete evacuation but not constipation. At 7-15 this is minimal, the higher you go, the bigger the anti-histamine constipation effect... If Benadryl constipates you (probably not), this will too I guess. C people probably should avoid. It also blocks the brain receptor responsible for anxiety, insomnia, and sexual dysfunction. It makes me pretty dull, and lethargic and drowsy, more so in the morning. This is mostly a problem at doses under 30mg..30 is a good dose, it wont make you so drowsy during the day(you take it at night because it pretty much knocks you out). The anxiety block is quite effective, for me its too effective. I think thats why it kinda supresses my personality.7-22mg youll be kinda drowsy, 30 is good, 45-60 is annoying. Pain wise, I don't know that it helps pain a lot per se, but if part of your pain problem is from anxiety, then it will help that pain. Im too lazy to explain why less of it makes you MORE drowsy, but it does. The Tricyclics (the old school anti-depressants) are supposed to help pain, by messing with the way your brain perceives pain or something. Personally, I haven't tried any. I'm not sure what they do D or C wise. Good luck, really if all you have is depression and some pain, it probably is anyones guess which one you should try first. An anti-spasmodic, if you havent tried them, may or may not help your pain, and may or may not cause some C.Slacker


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## trbell (Nov 1, 2000)

If you're depressed you probably should see a good shrink, but if it's just for pain a very low and 'non-therapeutic' dose of elavil, one of the old ones, often helps. chlordiasapam helps with acute gastric pain.tom


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## slacker (Mar 23, 2002)

trbell, Did you mean chlordiazepoxide (Librium)? That's just the benzo by itself. The brand name Librax is the 2 in 1 combo, chlordiazepoxide and clidinium, an anti-spasmodic. Elavil helps some people. I wish benzos or anti-spas drugs helped MY acute gastric pain =(.Slacker


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## gasbob (Dec 4, 2001)

NancyCat,Most Docs will probably be pushing and SSRI of some sort. This is not usually such a bad idea. But some of the old tricyclics may also be helpful. They are also extremely cheap.A previous poster suggested Elavil. If you have D, or generally feel that your bowel is a bit "accelerated", then this may do the trick.Bob


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## NancyCat (Jul 16, 1999)

I started taking elavil 10 mg about 5 weeks ago and noticed that from the 3rd day on I was getting very C for me. It didnt change the pain/sensations at all. Then after 3 weeks I had D for 2 weeks and got C again. I saw my GI doc yesterday and he changed the med to nortriptyline I think (pharmacy gave me imapram)10 mg for a week then 20mg if no improvement. he said elavil can be very constipating but that wherein he thinks I alternate its hard to tell if the elavil was doing it. All we can do is keep trying and he is so nice and caring and seems to really want to help me find something that works which is just wonderful, he's great, he absolutely GETS IT about IBS and I wish I had met him years ago.


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## NancyCat (Jul 16, 1999)

I deceided to stay with the elavil as my GI DR suggested and up the dosage a bit and see if the C becomes unmanagable (now its ok). I think I owe it to myself to try and give the elavil more time and a chance, till I'm sure it isnt helping or is making the C real bad, its hard to tell as I said being C and D. Thanks for everyones replies


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## honichou (Jun 30, 2002)

I have some more suggestions if the elavil becomes too sedating (it is one of the worst trycyclics as far as this is concerned):Trazodone - came before the SSRIs but works in a similar wayDesyryl - I think that this is classified for as something like a trycyclic; it is used all the time for chronic pain.They both have side effects, but they may be worth a try for you.Steven


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