# Amitriptyline only for IBS-D?



## Shell13 (Jun 25, 2012)

I have tried everything, diet, probiotics and several different antidepressants, and I'm so discouraged. A pharmacist recommended Amitriptyline today. I have been on it before, but not for IBS. I remember it made me sooo tired, but right now, I wouldn't care, so long as I had some relief. I have IBS-C and a little D. My main, awful symptom is pain. It's there all the time, but so much worse at night. Probiotics just gave me big-time gas, and other antidepressants just make pain worse. I'd like to try the Amitriptyline, but now I see on here that most people take it for IBS-D and I'm so scared it will make my constipation worse. Anybody have success with it that have other issues?? I can't take fiber supplements or anything because of gas, and I'm already as physically active as possible with all my pain, so constipation would be a huge issue.


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## Kathleen M. (Nov 16, 1999)

It is moderately constipating (not as much as some other things) so that can be an issue, especially if an osmotic/stool softener or more water isn't going to be enough to counteract it fo you.Zoloft can be used for IBS pain (as can other SSRI's, but Zoloft seems to be the one that speeds things up the mo). They may not be as good for the pain relief (or just aren't as well studied), but they do tend to speed up the gut so sometimes are used for those on the C side of things.Desipramine is related to Amitriptyline, but is in a different subset of Tricyclics and sometimes has fewer side effects (although will tend to be constipating) for some people so might be an option as well. It is commonly used for IBS.


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## Guest (Oct 15, 2012)

I also have IBS-C. I've been on Amitriptyline for a few years now. It will not make constipation worse. It is mostly to calm the colon so the pain will not be as bad. I highly recommend trying it. It has done wonders for me...go with the lowest dose though. I tried going up to 25mg. and it made my legs extremely jumpy! The 10 mg. doesn't do that! Hope this helps!!!


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## Shell13 (Jun 25, 2012)

Thanks, I think I will give Amitriptyline a shot. I need something more for pain, I've been on Domperidone for quicker motility (which it works great, but does NOT help with constipation). I find the side effects of other SSRI's are way too harsh. I'm hoping I have luck like you wolfpackgirl. Thanks.


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## Goldfinch (Sep 9, 2012)

I have noticed that many IBS sufferers are prescribed Amitriptyline (Elavil), which is a tricyclic antidepressant. It's a no-brainer that IBS can make you pretty depressed and anxious, and that anxiety and stress can contribute to gastric distress. I also have Interstitial Cystitis, and a lot of doctors prescribe Elavil for IC. As far as I can tell, there are two reasons for the heavy use of this med: one is that it can be a pain reliever and the other is that it has a side effect of being anti-cholinergic, or antispasmodic. Both IBS and IC sufferers can share pain as well as benefit from an antispasmodic. In addition, it may be a sleep-aid, for those who get drowsy from it.

I am guessing--and I could be wrong, so your insight would be appreciated--that Elavil is being prescribed by primary care docs and gastros because of those two benefits in the hope that it will also relieve anxiety/depression. Further I would venture to say that it is less often prescribed by psychiatrists. What sounds like a good idea, killing two birds with one stone to use an awful metaphor, may not be the best way to approach the emotional toll these diseases inflict. There are many anti-anxiety meds that can help, and everyone reacts differently to them. Most people who suffer from anxiety and nothing else are not taking Amitryptyline as far as I can tell. It is actually an old-line drug and there are many others that have been developed that better target anxiety. If it helps you on all fronts I'm all for it, by all means keep on taking it and read no further. To the previous poster, certainly try it if you have tried SSRI's and found them harsh in even small doses.

However, I see many posts by IBS and IC sufferers who complain that Am. does not help enough with their anxiety, plus it makes them sleepy. Some of these people have been on this drug for years. No doctor has prescribed any other anti-anxiety meds that might be a better fit for them; it isn't the only game in town. Finding the right med is trial and error, and doesn't happen overnight unless you are very lucky. The anti-spasmodic and pain-relief side effects can be achieved with other drugs. I take a plain low dose anti-spasmodic (Hyoscyamine) as needed and it is effective. I also take Prozac for anxiety and depression. I started taking it when I was diagnosed with IC about five years ago. It helps me immensely and I don't have any side effects--no sleepiness, no weight-gain, no mouth dryness, no digestive consequences. Gastros and pcp's may not be the best people to treat anxiety or depression. I suggest that anyone who is suffering from anxiety/depression as a result of IBS and who finds that Amitriptyline doesn't get the job done to your satisfaction, discuss with your doc the possibility of other drugs not in the tricyclic class or ask for a referral to a psychiatrist. Make sense?


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## Emilyy (Feb 19, 2011)

Nortriptyline is like Amitriptyline but usually better tolerated than the latter. I am on Nortriptyline and I have noticed less pain, I'm up to 30 mg but I am currently struggling with constipation so I might have to get it changed. I felt really tired on Nortriptyline for about 2 weeks, and then it passed as long as I took it the same time every night, I find if I forget and take it later that I will be tired the next day.


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