# Trying to decide Remeron or TCA therapy



## MDN (Mar 14, 2003)

Hey all, I posted this on the main IBS forum so sorry if you have to read it twice but I figured some people read only the anti-d forum







I am on Lexapro 10mg daily for IBS-D, anxiety, depression. and it does help some. But not good enough, and I belive it causes some GI upset and more D at times. Effexor was too strong as far as side effects for me. It seems my only options left as far as anti-depressants go is Remeron, or a TCA like Elavil or Pamelor. Which would you reccomend trying first for those symptoms I have? I know its trial and error but maybe someone can add some experience. My D is not so much real watery/loose D but rather frequant BM's throughout the day with pain/cramp/spasms afterwards. Also, does Elavil or Pamelor at the IBS doses do anything for depression or anxiety? It seems they are like 1/4 of the dose of their anti-D dose.Thanks for listening and helping with everything on my other posts. I am a 23 year old competitive bodybuilder and really need to get back into the sport and EAT more LOL thanks guys!!!!


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## Ganas (Jun 24, 2003)

I have alternating D & C but many cramps and pain and if it were not for the chest pains that I had 2 weeks on pamelor it would have been perfect it took away all of my symptoms and regulated my BM to once a day


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## MDN (Mar 14, 2003)

Do the TCA's do anything for depression even at such a low dose? Or it more of a pain/constipating side effect that makes it useful in IBS?


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## Kathleen M. (Nov 16, 1999)

Generally at the low doses they do not effect mood.The nerves in the gut use serotonin like the nerves in the brain, but in the brain the drug has to get across a barrier (that protects the brain from things and limits what gets in) so it may take a higher dose in the body to get enough in the brain to have a real effect. The nerves that use serotonin in the gut are not behind the same sort of barrier so I think that is why they can be effected at a lower dose than is needed to effect mood.K.


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## MDN (Mar 14, 2003)

Thanks guys!I guess I will see about trying Remeron at first to help with anxiety/depression as well. I can always try a TCA if that fails


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