Irritable Bowel Syndrome Message Boards | Re: Sibutramine for weight loss ?????

You should take a look at this. Gastrointestinal problems - including constipation - are listed as a possible side effect so it could be this drug is causing your apparent IBS flare.

A selective serotonin reuptake inhibitor (SSRI) fools around with how your brain processes serotonin - I don't remember exactly how any more. Since your gut also has tons of serotonin anything that impacts the serotonin in your brain is also going to impact the serotonin in your gut.

Since IBS is considered a brain-gut dysfunction, one of the theories for treating IBS is to fiddle with the serotonin that regulates gut function and/or lets the brain and gut communicate with each other. Because of this, anti-depressant medications which target brain serotonin are also used to treat IBS - with varying degrees of success. It appears that some SSRI-type anti-depressants work better for IBS-C while others work better for IBS-D.

Although it apparently does not act as an anti-depressant, Sibutramine is an SSRI so it is fooling with the serotonin in your brain and your gut. From what you're reporting, it sounds like its serotonin manipulation is not being good to your IBS-C.

Sibutramine also impacts norepinephrine and dopamine. If I remember correctly one of the common anti-depressants targets both serotonin and norepinephrine. I don't remember seeing any that also target dopamine although they may be out there.

The bottom line is that you're in the same situation as someone whose doctor is trying an anti-depressant to treat IBS: it might help, it might hurt, it might do nothing. In your case, it sounds like it's hurting.

If I were you I would call my GP, explain you're having problems, and see how to step down from this drug for the time being. Do NOT just stop taking it - simply quitting an SSRI without a doctor's advice is a very, very bad idea and I have a vague sense that when that SSRI is combined with a norepinephrine inhibitor it's an even worse idea. See if your symptoms subside once you've been off Sibutramine for a while - it can take a while for the drug to clear your system and may then take a while longer for your gut to calm down.

If your GP really, really insists you keep taking this drug, go back to your GI and talk to him about it. He should know best whether this is really advisable given your IBS.

If you want another viewpoint or I've not been clear - I tend to ramble sometimes - then if you don't get any more responses on this Board try posting on the Diet Board. That Board gets more traffic than this one.

HTH. Good luck.

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