IBS-D and Anxiety Drugs
#316714 - 10/15/07 05:57 PM
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This is my first post, and I can't tell you how wonderful it was to stumble on these message boards. Just realizing that I'm not alone made my eyes well up with relief.
I've struggled with symptoms of IBS-D for 10 years, (though was only officially diagnosed a year ago) and with panic disorder for about 15 years. Day to day, I've found a lot of success controlling my IBS with diet and supplements (I'm a huge fan of acidophilis, and just ordered Heather's acacia powder). However, when I'm feeling anxious, NOTHING helps. I've even had D with a couple of doses of Immodium in my system.
I'm starting to think that some kind of anti-depressant might help kill both birds with one stone. I've done some research: I've heard that SSRI's only work for IBS-C, but is that a hard-and-fast rule? I'm really not sure how I feel about tricyclic antidepressants-- I was a psych major in college and know that they're kinda "dirty" drugs.
I've discussed some of this with my doctor, but she (like most, it seems) is not very well informed on the subject. I would love some feedback on what has worked and what hasn't for all you IBS-D sufferers out there, so I can bring it to my doctor.
Thanks for listening, and just being there.
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IBS-D with pain and occasional cramping, compounded by panic disorder that occasionally morphs into generalized anxiety.
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I take Lexapro and one of the side effects listed is constipation. I actually have IBS-A and when I started the Lexapro I took a stool softner to help offset any C - but it really did not seem to be a problem. I also have taken Librax, which is an antispasmodic and a antianxiety one several occasions when I have something coming up. Most recently I took it during my vacation and it does tend to give me constipation. I, like you, have anxiety/panic attacks and when they flair up so does the IBS. It seems to feed off each other till I can get them calmed down.
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There is a good section beginning with the heading "Tricyclic antidepressants" on the use of antidepressants for treating IBS in this article. Heather makes some comments about antidepressants on this web page. Usually tricyclic antidepressants are used in low dose, below theraputic levels for use with depression. The side effects are greatly, if not completely, reduced.
Good luck 
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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I take Lexapro 10mg daily for panic disorder, I have taken it for about 5 years and have no problems.
IBS-D
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Welcome to the Boards.
I took Elavil (the tricyclic AD Amitriptyline) for a while. I started at 25mg. It did shut down my diarrhea but I found the side-effects extremely unpleasant. The side-effects did back off a little after a while but then the anti-diarrheal effect began to fade so my doctor upped the dosage to 50mg. Relief, more side-effects, relief stopped, upped the dosage to 75mg. At that point the side-effects were more than I could take so I dropped the med. On the other side of the coin, my doctor prescribed Elavil for me because she had had very good luck with it for other IBS-D patients so my experience may be atypical.
For a variety of reasons I've been having trouble with anxiety for the last 6 months or more - not panic attacks but enough situational anxiety to crank up my IBS-D from time to time. I do very well taking Lorazepam (generic Ativan, 0.5mg tablet) as needed. If I'm having a particularly bad day, I'll also take Imodium.
HTH.
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[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
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My first experience with tricyclic antidepressants, about twelve years ago, was not very good and I experienced a lot of side effects. It turned out I was on a fairly high dose and that -- combined with Lomotil and Donnatal -- made me a zombie.
But about two years ago, around the time I was diagnosed with lupus, I decided to try Elavil. My doctor started me on a very low-dose of Elavil, 5 mg and now 10 mg, and that's worked really well for me. It does help with the IBS-D, IBS pain, and also with pain and insomnia associated with lupus. I'm also on Buspar, for anxiety, and I've learned that it's also being considered/studied as a possible IBS medication. I take lorazepam/Ativan as needed for panic attacks, but also for very bad IBS attacks (which I haven't had for a long time now).
I hope you find something that helps you! I understand what you're going through -- the panic attacks, the D. Sometimes it's hard to know what came first!  I recommend if you do decide to try a trycyclic AD to start at a low dose. Best wishes!
Edited by Maria!Maria! (10/16/07 11:33 AM)
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