# nortriptyline for non-D-predominant



## kc99 (Jun 7, 2007)

Hi everyone, I was wondering if anyone out there who is not diarrhea-predominant (so, IBS-C/A/M/P/PI or whichever letter you associate with) has had any luck with low-dose nortriptyline -- or any other TCA, really. I have been getting the impression that TCA's are becoming increasing popular for the non-D categories, in combination with miralax or something of the sort to fend off the constipation side effect. I've been offered this before myself, and Peter Whorwell mentioned it in one of his online videos, which it seems some people around here have seen before (e.g., http://www.videomd.com/AntidepressantsforIBS-fv-2432.aspx).Anyways, I know no individual's experience is a good predictor of how well it would work for me, but I was just curious if there is anyone out there, non IBS-D, who has been helped by it.


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## Jillywindy (Jan 17, 2010)

I'm, IBS-P and am taking 30mg of amitriptyline/day. No constipating side effects. Seems to reduce the pain so that I'm pain free most of the time but I still have painful episodes sometimes that it doesn't seem to affect.


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## kc99 (Jun 7, 2007)

Thanks Jillywindy. I'm surprised you didn't get constipation issues. I'd be interested to know if you got any side effects at all or if you managed to dodge them altogether.


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## Jillywindy (Jan 17, 2010)

Actually the only side-effect is really rather nice in that I'm sleeping much better. I am also a bit groggy in the morning but that's ok. I may have experienced the dry mouth and metallic taste vaguely when I first started but nothing now. I've been taking psyllium hulls regularly although I've never had D or C so that may explain why I didn't get any C. I also eat a whole unpeeled kiwifruit first thing in the morning which probably also helps.


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## kc99 (Jun 7, 2007)

OK, interesting...definitely understand where you're coming from with the sleeping thing. Did you find that you had any increased jumpiness or nervousness at first? (some people on the forums have mentioned this). Sorry...not to put you to work answering 500 questions


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## Jillywindy (Jan 17, 2010)

No increased jumpiness. Probably the opposite. Early morning grogginess is becoming a bit of an issue at the moment. I'll try taking it earlier in the evening and see if that helps.


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## kc99 (Jun 7, 2007)

OK, good luck with that! I really appreciate all your patience in answering all my questions. Thanks!


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## Zanne (Nov 22, 2004)

Hi I'm a IBS-C/M/P and I use the TCA doxepin for severe abdominal pain and have had good success with pain reduction. I take 50mg daily in the evening. It does make you drowsy, but that side effect wore off for me in a week or so, but they often recommend that you take it in the evening or before bedtime. TCA's have the side effect of constipation. And I have had CC since early childhood. Zelnorm had been my miracle drug, but when it was no longer available, my life reverted back to one of constant abdominal pain. Thankfully the daily 50mg doxepin really helps with the pain. I was concerned that it was worsening my C, so last summer/fall I weened myself off and then went totally without doxepin for 6 weeks. The pain returned with a vengence but the C got no better. So I concluded the doxepin was not making my C any worse.Here is an exerpt from an interesting study:http://www.ncbi.nlm.nih.gov/pubmed/19340896 (click on FULL-TEXT ONLINE is upper right corner or try this link)http://www.wjgnet.com/1007-9327/15/1548.aspEfficacy of tricyclic antidepressants in irritable bowel syndrome: A meta-analysisTCAs exhibit clinically and statistically significant control of IBS symptoms; however, given their abundant side effects they should be reserved for moderate to severe cases. Subjects should be started on subtherapeutic doses for depression and choice of drug should be tailored for each individual. We suggest using TCAs with the least anticholinergic effects (i.e. doxepin and desipramine) for elderly patients or constipation-predominant IBS and imipramine or amitriptyline for diarrhea-predominant IBS and patients with insomnia.And here is another article from GUT:Antidepressants for irritable bowel syndromehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773590/Now if I could only find something for my CC due to impaired motility. I'm in the USA and would really like to try Resolor (prucalopride), but it just makes me want to cry to think the earliest we may see it here is 2012. I manage with a very strict diet and Omnigest EZ (digestive enzymes) for the gas/bloating/distention. I've had it with GI's. All those things that make other people GO have no effect on me. For my last colonoscopy prep - they had me mix up and drink an entire bottle of Miralax plus some Ducalax tablets. My gut blew up like a balloon and I had severe pain, but nothing came out. It was beyond horrible...the GI's just scratch their heads...Gee we've never seen that happen before. Needless to say I won't go near Miralax.Good luck if decide to try a TCA.


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## kc99 (Jun 7, 2007)

Hey Zanne -- haven't checked in here for a while (obviously) but thanks very much for your input!


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