About Amitriptyline For IBS

About Amitriptyline for IBS including dose, side effects, interactions and use in pregnancy. Leave reviews and discover other visitors comments.

This medication has not only antidepressant qualities, but can be used to relieve pain and stomach cramps, help settle diarrhea, reduce stress and anxiety and aid restful sleep too. 

Its an excellent drug that has been available for many years, with a good safety profile when used correctly.  It is in a group of drugs called tricyclic antidepressants which work by modifying the pain messengers in your brain. The most common trade name for this drug is Elavil.

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What Is Amitriptyline?

Amitriptyline For IBS Picture
Amitriptyline For IBS Picture

This is a tricyclic antidepressant medication that is commonly used for mental health problems. However, it prolongs the activity of a neurotransmitter called seretonin in the brain and gut as well as noradrenaline and Amitriptyline for IBS symptoms is commonly prescribed by doctors.

Indications

Amitriptyline for IBS as a treatment has non-licenced use in Irritable Bowel Syndrome, However, it is commonly used off licence by doctors (like many other drugs)  for this condition.

It is also used in:

  • Depression
  • Enuresis or bed wetting in children
  • Chronic Pain Syndrome
  • Anxiety and stress
  • Insomnia to aid sleep
  • Migraine

Drug Names

The medications trade names include:

  • Elavil

  • Tryptizol
  • Endep
  • Saroten
  • Trepiline
  • Tryptanol

Cautions

The drug should be used with caution in:

  • Heart disease
  • Epilepsy
  • Pregnancy and Breast Feeding
  • Elderly  People
  • Liver Disease
  • Thyroid Disease
  • Phaeochromocytoma
  • People with mania and psychosis
  • A history of drug sensitivity
  • When taking other medications
  • Glaucoma
  • Urine retention

Always discuss this with a health care professional.

Contraindications

The treatment is contraindicated in people who:

  • Have had a recent heart attack or myocardial infarction
  • Have palpitations with heart irregularities
  • Have severe liver disease

Side Effects

Side effects of Amitriptyline for IBS include:

  • Dry mouth
  • Drowsiness
  • Blurred Vision 
  • Constipation
  • Difficulty passing urine
  • Nausea
  • Positional low blood pressure
  • Fast heart rate
  • Sweating
  • Tremor
  • Rashes
  • Hypersensitivity to the medication
  • Behavioral changes
  • Hypomania or mania
  • Confusion
  • Interference with sexual function
  • Blood sugar changes
  • Increased appetite
  • Weight gain/loss
  • Hormone changes
  • Movement disorders
  • Blood disorders
  • Salt imbalance
  • Abnormal liver function tests

Dose

In adult Irritable bowel syndrome, the dose is normally started low at 10 mg at night.

This can be increased to a maximum dose of 150 mg. The lower dose is less likely to cause side-effects.

Some Drug Interactions

Alcohol - increases sedative effect

Analgesics - possible increased risk of convulsions or fits with Tramadol

Anti-arrhythmic drugs - Amiodarone, Disopyramide, Procainamide, Propafenone and Quinine. RIsk of heart rhythm disturbance including ventricular arrhythmias with trcyclic medications.

Antibiotics - Rifampicin reduces the effectiveness of Amitriptyline

Anti-epileptics may reduce the effectiveness of Amitriptyline

Antihistamines - increased risk of sedative effects. Increased risk of heart rhythm disturbance with Astemizole and Terfenadine

Anti-Hypertensives - may enhance the blood pressure lowering effect. Diltiazem and Verapamil may increase the drug levels of Amitriptyline

Anti-psychotic medications - increased sedation and risk of heart rhythm disturbance

Diuretics "water tablets" such as Furosemide and Bendroflumethazide - increased risk of low  blood pressure

Muscle relaxants - increased relaxant effect with Baclofen

GTN (Glyceryl trinitrate)/Nitrates - may reduce the effect of GTN administered under the tongue due to dry mouth. May increase hypotension or low blood pressure

Oral contraceptives - estrogens and progestogens block Amitriptyline effect, but increase the blood levels.

Anti-ulcer drugs - Cimetidine increases Amitriptyline blood levels

Can I take this drug in pregnancy?

Like any drug, a discussion with your doctor if you are taking Amitriptyline for IBS before pregnancy is advisable.  There is evidence that it may increase risk of pre-eclampsia.

Amitriptyline in IBS patients can usually be swapped for alternative options. If needing to take this medicine, the potential benefits and risks need to be discussed. The drug needs to be withdrawn gradually to prevent withdrawal symptoms such as:

  • Nausea and Vomiting
  • Dizziness
  • Irritability
  • Insomnia or difficulty sleeping
  • Restlessness
  • Palpitations and increased anxiety

Can I breast feed with this medication?

Amitriptyline dose pass into breast milk in small amounts so it should be avoided if possible. However, this does need discussing with your doctor as you may be able to continue the medication, depending on need. If taking the medication whilst breast feeding your baby will need to be monitored for sedation. In most cases this isn't usually an issue. 

The Key To IBS Freedom
The Key To IBS Freedom

The Doctors View On Amitriptyline For IBS

Amitriptyline has been used as treatment for a long time now.

It has very special qualities that suit certain sufferers. These include sedating effects for those who have trouble sleeping, pain relieving qualities which are important in some sufferers who have significant pain issues and can also help in the regulation of your bowel.

It is best in diarrhea predominant symptoms as it has the so called "anticholinergic effect". This results in a reduction of bowel motility so constipation sufferers are less likely to gain the benefits from it (and can have worsening symptoms).

Some sufferers can't tolerate the drug because of its "hangover effect" from it's sedative properties. For those getting up early in the morning to work, in driving or anyone operating machinery, drowsiness can be a problemativ issue. In this situation, the use of the newer SSRI's might be an alternative.

Reviews

Linda's Review (UK)

I have taken Amitriptyline for IBS over several years. I decided to stop taking it as I thought it would help with weight loss and the stigma of taking an anti depressant. My IBS has come back with a vengeance  I am in more pain than ever before. I have started the Amiitryptline again and hope it will work again but I know it might take up to 3 weeks to get back to normal. You don't know how well the Amititryptline is working until you stop taking it.

Chris's Review (USA)

At age 50, having numerous symptoms, my last visit to the ICU for IBS-D. I was sent home with a couple of new treatments I had never taken before, one being Elavil (I assumed it were for sleep, since it said take at bed time,…. I didn't.) I was taking Ambien for sleep and didn't want to OD on sleep treatments. So I never took the prescription. My 1 month check after the hospital, I was symptomatic again, and afraid I would have C-Diff again. So in looking at my RX's to see if there was a bad combination, he noticed my full bottle of Elavil, and questioned it. I told him I assumed it was for sleep. ( I am a person that if I get 4 hours total a night, it's a good night.) When I left his office he didn't prescribe new RX. Just told me AGAIN, why he had prescribed the drug. (I guess in the hospital I didn't take it all in.) So I saw my G.P. on Friday, she was concerned that my heart rate was up, I had a temp, chills, wiped out. She even test me for the FLU. I decided to just sleep it off this weekend and see a doctor on Monday. I slept all weekend. Remember I'm a 4 hour a night MAX girl. I slept all weekend. I have Neck issues (Degenerative Disc, Hern. Disc, ) that affect both arms and hands. (I get nerve blocks for these). I have had my right knee scoped, and monthly migraines. My husband of 20 years will tell you, I have a tremendously HIGH tolerance of pain. I googled Elavil, for the side effect of dry mouth. And yes I have dry mouth. But I am SHOCKED to say that my many other symptoms are much better. And sleep, oh my how I have missed sleep. 10mg. I'll take a dry mouth any day, for the tradeoff. I have searched for relied for my neck for years, and have been taking Ultram (Tramadol). I wish that Elavil (or Amitriptyline for IBS symptoms I had) had been suggested long before now. I plan to come off as many of my other treatments as possible.

Deb's Review (UK)

I take Amitriptyline for IBS occasionally when my symptoms are particularly bad. I get acute diarhoa and as soon as I awake my bowel goes into spasm. The quicker I have to move in the morning the worse it will be. It will wake me in the night too. 10mg will slow it down enormously.

Kristy (Australia)

Amazing! Ibs-d sufferer for 10 years. Suffered severe cramps, and the sight of food made me run to the toilet. My doctor prescribed 10mg at night. Took 6 months of convincing to take them and I am on my 3rd month. I can eat food again, do not have the severe cramps I used to, and bowel movements to 1 a day. I feel normal again. Can't believe I didn't hear about this drug sooner.

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