Amitriptyline for IBS(Guide)

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. 

IBS is a chronic condition that you’ll need to manage long term.

What is amitriptyline?

Amitriptyline is a tricyclic antidepressant.

Amitriptyline affects chemicals in the brain that may be unbalanced in people with depression.

Amitriptyline is used to treat symptoms of depression.

What is IBS?

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder characterized by symptoms of altered bowel habits and abdominal pain or discomfort.

Symptoms of IBS are thought to be due to a combination of abnormal intestinal motility and intestinal hypersensitivity to stimulation.

It causes discomfort and distress, reducing people’s quality of life. 

Environmental factors (psychological disturbances and stress), genetic links, recent infection, bacterial overgrowth, food intolerance, altered bowel motility and secretion, visceral hypersensitivity, altered central nervous system sensory processing, disturbed autonomic nervous system regulation, and serotonin deregulation are all proposed as possible etiological factors for IBS.

Can Amitriptyline be used for irritable bowel syndrome?

Tricyclic agents such as amitriptyline and imipramine were initially prescribed to IBS patients with significant depression.

Today, they are frequently used to treat patients with severe or refractory IBS symptoms and may have analgesic and neuro modulatory benefits in addition to their psychotropic effects.

How to take amitriptyline

Your dosage, drug form, and how often you take the drug will depend on:

• Your age
• The condition being treated
• The severity of your condition
• Other medical conditions you have
• How you react to the first dose

Drugs you should not take with amitriptyline

Taking certain drugs with amitriptyline may cause serious side effects.

You should not take these drugs and amitriptyline at the same time.

Examples of these drugs include:

• Monoamine oxidase inhibitors (MAOIs). Examples of these drugs include:

• Phenelzine
• Tranylcypromine
• Selegiline

Using an MAOI with amitriptyline can lead to seizures or even death.

Do not take an MAOI within two weeks of stopping amitriptyline, unless told to do so by your doctor.

Also, do not start taking amitriptyline if you stopped taking a MAOI in the last two weeks, unless told to do so by your doctor.

If you aren’t sure whether any of the drugs you take is an MAOI, ask your doctor or pharmacist.

• Quinidine. Taking this drug with amitriptyline could increase the amount of amitriptyline in your body. This could lead to dangerous side effects.

Amitriptyline side effects

Get emergency medical help if you have signs of an allergic reaction to amitriptyline: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• unusual thoughts or behavior;
• a light-headed feeling, like you might pass out;
• chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
• pounding heartbeats or fluttering in your chest;
• confusion, hallucinations;
• a seizure (convulsions);
• painful or difficult urination;
• severe constipation;
• easy bruising, unusual bleeding; or
• sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, red or swollen gums, trouble swallowing.

Warning Signs of Amitriptyline

This drug has a black box warning. Here are the most serious warning signs from the Food and Drug Administration (FDA). 

Worsening depression warning

You might experience an initial worsening of your depression, thoughts of suicide, and behavioral changes when you first start taking amitriptyline.

This risk may last until the drug starts working for you.

Withdrawal symptoms warning

If you’ve been taking this medication for a long time, you shouldn’t stop taking it suddenly.

Stopping it suddenly may cause side effects such as nausea, headache, and tiredness.

Don’t stop taking this drug without talking to your doctor. They will tell you how to slowly lower your dosage over time.

Dementia warning

This type of medication can cause effects similar to those caused by drugs called anticholinergics.

This can raise the risk of dementia.

Allergy warning

This drug can cause severe allergic reactions. Symptoms can include

• skin rash or hives
• trouble breathing
• swelling of your face or tongue

Alcohol interaction warning

The use of drinks that contain alcohol while taking amitriptyline raises your risk of serious side effects, including extreme drowsiness.

Warnings for people with certain health conditions

For people with heart disorders: Taking this drug could cause heart problems, such as irregular heart rhythm, heart attack, and stroke.

Do not take this drug if you’re recovering from a recent heart attack.

For people with bipolar disorder: Before starting you on treatment with antidepressants such as amitriptyline, it’s important for your doctor to check your risk of bipolar disorder.

Your doctor should do this because a major depressive episode is usually the first symptom noticed in people with bipolar disorder.

This drug should not be used in people with bipolar disorder.

For people with a history of seizures: Taking this drug raises your risk of seizures.

If you have a history of seizures, your doctor will monitor you closely while you’re taking this drug.

If you have a seizure while taking this drug, stop taking it and call your doctor right away.

For people with a history of glaucoma or increased eye pressure: Taking this drug could increase the pressure in your eyes.

If you have a history of glaucoma or increased eye pressure, your doctor will monitor you closely while you’re taking this drug.

https://medlineplus.gov/druginfo/meds/a682388.html

https://www.healthline.com/health/irritable-bowel-syndrome

https://www.ncbi.nlm.nih.gov/pubmed/9715427

Conclusion

Irritable bowel syndrome (IBS) is a common condition that affects the digestive system.

It causes symptoms like stomach cramps, bloating, diarrhea and constipation. 

These tend to come and go over time, and can last for days, weeks or months at a time.

It’s usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life.

There’s no cure, but diet changes and medicines can often help control the symptoms.

Amitriptyline is a prescription drug that is used in the treatment of BPI. 

Amitriptyline works on your central nervous system to increase the level of certain chemicals in your brain, which improves your depression.

Frequently Asked Questions (FAQ)

Citations

Videlock EJ, Chang L. Irritable bowel syndrome: current approach to symptoms, evaluation, and  

       treatment. Gastroenterol Clin North Am. 2007; 36: 665–685

Wilson S, Roberts L, Roalfe A, Bridge P, Singh S. Prevalence of irritable bowel syndrome: a 

       community survey. Br J Gen Pract. 2004; 54: 495–502