Depression Learning

antidepressants

Question:

I’ve had mixed success with antideprssants.  When using Tofranil, it constipated me -which was great.  But after a few weeks, I would have constant ringing in my ears, which was driving me nuts.  I then switched to Zoloft, which makes me less depressed, but does not seem to do much for my IBS. Any other similar experiences out there?

Response:

- Hide quoted text — Show quoted text -Dawn S Friedman wrote: > In article <01bce195$4fedea20$736848a6@default>, > Thomas P. Botsolas <bots…@ibm.net> wrote: > >I’ve had mixed success with antideprssants.  When using Tofranil, it > >constipated me -which was great.  But after a few weeks, I would have > >constant ringing in my ears, which was driving me nuts.  I then switched to > >Zoloft, which makes me less depressed, but does not seem to do much for my > >IBS. Any other similar experiences out there? >   Yes.  It’s generally the case that tricyclic antidepressants like > Tofranil are not only constipating, but (for some people) they protect > against other IBS symptoms.  I had chronic low-level pain and nausea, > and desipramine protects me against that. >   The SSRIs (Prozac, Zoloft, Paxil) are good antidepressants too, > but they aren’t usually as good against IBS.  (For the same reason > that they’re often thought of as having fewer side effects than the > tricyclics — that constipation is helpful for you, but a pain for > someone else.  The SSRIs don’t press the same buttons in the body.) >   The good news is that each medication has a slightly different > side effect (and direct effect) profile, and that each person > responds differently to any given drug.  It might be worthwhile to > try a little of one of the other tricyclic drugs along with your SSRI. > It’s possible that only a little will be enough to suppress your > IBS (especially since the SSRIs keep the tricyclics in your system > longer; if 100 mg of Tofranil worked for you taken alone, you might > need half or a quarter of that with the Zoloft.  So you’ll need more > blood levels.)  That small amount might prevent the ringing, or > the fact that it’s a different drug might avoid it, too. >   Here’s *my* question:  how are they doing coming up with drugs > that are *just* for IBS?  I don’t want to stay on desipramine > forever; I want to go off it when I don’t need it for the > depression.  But the last time I did that, the IBS pain came back, > and after three months of that, so did the depression (you guys > know how empowering and fulfilling chronic pain is), so there > was no point in staying off it.  Just as in the first poster’s > case, when I tried other antidepressants, they helped the > depression but the IBS came back — in fact, the medication > actually made it much worse.  And each time I make one of these > little experiments, it takes me a couple of months to stop > hurting and be able to eat normally again. >   I don’t think I want to venture off desipramine again until > someone says, "This drug has a good chance of suppressing your > IBS pain."  And it probably can’t be (for the long term) > either Levsin (which puts me to sleep, which is great in a > crisis but not practical for every single day) or Donnatol > (the phenobarbital in that has two problems for me: > it’s a depressant itself, and it encourages the liver enzymes > that break down Zoloft…) >   I love the wondrous complexity and interconnectedness of human > biochemistry, don’t you?  It’s like living in a Rube Goldberg > terrarium. > — > Dawn Friedman      d…@world.std.com

For those of us with IBS taking antidepressants for fibromyalgia, the drugs apparently reduce the IBS symptoms and other problems by helping our bodies produce more serotonin and other neurtransmitters lacking in our bodies in sufficient quantities to normally regulate the smooth muscle of the gut.  The SSRI’s that many of us also take are intended to help us use the serotonin we have more efficiently.

Response:

In article <EJ5u46….@world.std.com>, d…@world.std.com (Dawn S Friedman) wrote: >  Here’s *my* question:  how are they doing coming up with drugs >that are *just* for IBS?  I don’t want to stay on desipramine >forever; I want to go off it when I don’t need it for the

There are a number of drugs in development specifically for IBS. Glaxo-Wellcome is the leader with Alosetron and Fedotozine. Smith-Kline has an unnamed drug. Pfizer has Darefanecin and company I can’t recall the name of has Cilanestron. Unfortunately, everyone has to wait a few years before they are available. >drugs apparently reduce the IBS symptoms and other problems by helping >our bodies produce more serotonin and other neurtransmitters lacking in >our bodies in sufficient quantities to normally regulate the smooth >muscle of the gut.  The SSRI’s that many of us also take are intended to >help us use the serotonin we have more efficiently.

It looks as if blocking serotonin in certain ways is the key to treatment. This is what many of these new drugs do. — Maurice Volaski, Flux Software         supp…@fluxsoft.com http://www.fluxsoft.com/     ftp://ftp.fluxsoft.com

Response:

  Have you ever considered drugs of the mebeverine type? Are they available in the US? The point would be that these drugs act directly on the muscle cells of the gut, tending to cause a relaxation. Many IBS symptoms are thought to originate from an abnormally high tension of the gut wall. The antidepressants (tricyclic or SSRI) address the nerve endings impinging the gut muscle, but not the muscle itself. So at least in theory, mebeverine-type medication would be well-suited to be combined with the nerve-directed drugs, and perhaps allow to lower their dosis. It should also make sense to combine it with Levsin (which blocks nerve-muscle conduction), perhaps lessening the Levsin side effects. Mebeverine is related to papaverine. It has worked well for me against cramps, although I have taken it only "as needed", not chronically. It seems to be a rather "mild" drug though, so I would not recommend it for people with severe attacks. Marek – Hide quoted text — Show quoted text -Dawn S Friedman wrote: > In article <01bce195$4fedea20$736848a6@default>, > Thomas P. Botsolas <bots…@ibm.net> wrote: > >I’ve had mixed success with antideprssants.  When using Tofranil, it > >constipated me -which was great.  But after a few weeks, I would have > >constant ringing in my ears, which was driving me nuts.  I then > switched to > >Zoloft, which makes me less depressed, but does not seem to do much > for my > >IBS. Any other similar experiences out there? >   Yes.  It’s generally the case that tricyclic antidepressants like > Tofranil are not only constipating, but (for some people) they protect > against other IBS symptoms.  I had chronic low-level pain and nausea, > and desipramine protects me against that. >   The SSRIs (Prozac, Zoloft, Paxil) are good antidepressants too, > but they aren’t usually as good against IBS.  (For the same reason > that they’re often thought of as having fewer side effects than the > tricyclics — that constipation is helpful for you, but a pain for > someone else.  The SSRIs don’t press the same buttons in the body.) >   The good news is that each medication has a slightly different > side effect (and direct effect) profile, and that each person > responds differently to any given drug.  It might be worthwhile to > try a little of one of the other tricyclic drugs along with your SSRI. > It’s possible that only a little will be enough to suppress your > IBS (especially since the SSRIs keep the tricyclics in your system > longer; if 100 mg of Tofranil worked for you taken alone, you might > need half or a quarter of that with the Zoloft.  So you’ll need more > blood levels.)  That small amount might prevent the ringing, or > the fact that it’s a different drug might avoid it, too. >   Here’s *my* question:  how are they doing coming up with drugs > that are *just* for IBS?  I don’t want to stay on desipramine > forever; I want to go off it when I don’t need it for the > depression.  But the last time I did that, the IBS pain came back, > and after three months of that, so did the depression (you guys > know how empowering and fulfilling chronic pain is), so there > was no point in staying off it.  Just as in the first poster’s > case, when I tried other antidepressants, they helped the > depression but the IBS came back — in fact, the medication > actually made it much worse.  And each time I make one of these > little experiments, it takes me a couple of months to stop > hurting and be able to eat normally again. >   I don’t think I want to venture off desipramine again until > someone says, "This drug has a good chance of suppressing your > IBS pain."  And it probably can’t be (for the long term) > either Levsin (which puts me to sleep, which is great in a > crisis but not practical for every single day) or Donnatol > (the phenobarbital in that has two problems for me: > it’s a depressant itself, and it encourages the liver enzymes > that break down Zoloft…) >   I love the wondrous complexity and interconnectedness of human > biochemistry, don’t you?  It’s like living in a Rube Goldberg > terrarium. > — > Dawn Friedman      d…@world.std.com

Response:

Related Depression Posts

• Interesting table
• Tiredness and Depression
• what med; can I ask tomorrow?
• Need advice from folks who know about SSRIs
• Don't know what to do–stinkin' thinkin' ahead
• Depressing day
• Margrove..Jackie..anybody..med question – help.