Does anyone have any experience of taking the Tricyclic ‘Amitriptyline’ for IBS-D, in particular any weight gain issues ?

I have been prescribed amitriptyline, 10 or 20 mg daily.  However, I have read that it commonly leads to weight gain and while I am skinny, I have no wish to whack on a whole load of weight which will increase with time.

I have been trying to control my IBS-D with Imodium and failing miserably. 

 

 

Hello,

I have been taking amitriptyline for IBS for 20+ years. I originally started on 10 mg daily with dinner and then settled on 25 mg daily with dinner.

I am skinny too and it hasn't helped me with weight gain at all. Perhaps in 150 mg daily doses it might cause you to gain weight. For IBS-D you do not need a large dosage. In fact, amitriptyline at high doses are dangerous for your heart and a lot more other side effects.

It will take 4-6 weeks to notice any difference when you start it. You will be extremely sleepy for the first 2 weeks. Careful driving. That's why it is best taken early in the evening so that the side effect of sleepiness wears off by morning. Your body eventually gets used to it and it doesn't make you sleepy after about 2 weeks. You will get sleepy again if you increase the dosage.

Many thanks for your reply. It was extremely helpful and interesting.

I must admit to having a fear of taking a long term medication such as an anti-depressant and also of gaining weight despite being unhealthily underweight. It seems from your experience that neither factor would or should be a problem.

Two things still bother me though. Do the pills become less effective at that dosage over time so you need to continually increase the dosage ? I appreciate that it may not be the same for everyone and each person must find the right dosage for them but in your experience, do the pills allow you to live a normal pain-free, IBS symptom free life ?

22 hours ago, Higgie D said:

Two things still bother me though. Do the pills become less effective at that dosage over time so you need to continually increase the dosage ? I appreciate that it may not be the same for everyone and each person must find the right dosage for them but in your experience, do the pills allow you to live a normal pain-free, IBS symptom free life ?

It has not been my experience that amitriptyline loses its effect over time. It's very steady once you adjust to it. BTW, antidepressants have been renamed as central neuromodulators because of the stigma of the term antidepressants.

No, amitriptyline does not provide a normal pain-free IBS symptom free life. That does not exist with any treatment. Medications are currently managing the symptoms of IBS. We don't know the cause of IBS and don't have a treatment that "cures" it. Treatments help you cope and smooth out the worse symptoms. You will still have days that are not ideal, but those don't happen as often with the right treatment.

Ok. I’m so grateful that you took the time to reply. I feel that I know the long and short of it now and will have to consider the way forward.

I have always suffered with ‘gut’ trouble, as did my father, but with increasing age, it has become significantly worse until it is now out of control. Undoubtedly, the biggest causative factor is stress, much of which is probably self-induced. So reducing this  would seem a good place to start. I have started a food diary as another approach.

However, now I can see that amitriptyline may be the best way to go, if my other approaches do not yield sufficiently positive results.

Many thanks for your help. It has been much appreciated.

You are very welcome. Just remember that it takes 4-6 weeks to see the results of taking amitriptyline. At such a low doses it's not likely to help with anxiety or depression, but it might give a small nudge in the right direction to help with stress levels. You'll be very tired for the first 2-3 weeks. You will adjust if you stick to it. I take it at dinner time and it doesn't interfere with my evening at all, but helps with sleep at the appropriate time.

I started Amitriptyline 10mg about 4 weeks ago and haven’t noticed much so I’m curious, what did you notice? What should I expect?

I was originally prescribed 25mg but asked to start at 10mg. I may double it and go to 20mg but I’m just curious what your experience was/is. How is it helping you?

I took the amitriptyline daily for about 6 weeks at 10 and then 20mg with no problem at all. It worked well for me with no side effects for the time I took it although it did take 3-4 weeks to kick in. I only stopped it because there was so much talk on line about putting on vast quantities of weight very rapidly. However, Mr Roberts assured me that he hadn’t put on weight after 20 years of taking it. However, by then, I’d returned to Loperamide and have been managing with varying degrees of success. Undoubtedly though,  I would be better on Amitriptyline and may well go back to it.
As a side issue, I have increased my daily liquid consumption, mainly water, to 2- 3 litres and surprisingly, it has helped my IBS-D a lot in so far as I don’t experience anywhere near as much gut pain. Perhaps I just wasn’t drinking enough before ?

Edited November 19, 20241 yr by Higgie D
Omitted an important point

11 hours ago, Nick0 said:

I started Amitriptyline 10mg about 4 weeks ago and haven’t noticed much so I’m curious, what did you notice? What should I expect?

I was originally prescribed 25mg but asked to start at 10mg. I may double it and go to 20mg but I’m just curious what your experience was/is. How is it helping you?

Everyone is different and some can manage with more or less before any changes are noticed. You might need to double to 20 mg before you notice anything.

Mainly, it could slow down the number of loose stools you have daily along with less intense abdominal pain around meals and especially first thing in the morning.

I have now been taking Amitriptyline 25mg for 3 months and I’d say it has improved pain 99% urgency 99% diarrhea %50. That is a massive win for me having ibsd for that 30 years.
That said there is talk about side effects and long term effects and it has me a little worried. 
Is anyone having good success with any other drugs?  For me Pain and urgency I have found are much more important for quality of life then the diarrhea.

what is everyone else finding works for pain and urgency?

Does anyone else share my concern with Amitriptyline or am I over thinking it? Cardiac problems and dementia are not insignificant later in life. 

Edited January 22, 20251 yr by Nick0

@Nick0 that is really wonderful to hear! Good for you that you found something that has really worked for you.

25mg is the dose that helps me too without any troubling side effects. As I said in an earlier post, I have used it for 20+ years. Maybe I'll see something when I'm elderly in terms of long term side effects. Who knows. Every medication has issues.

Besides amitriptyline, I have used Viberzi and it works quite different. The results are almost instant. You cannot take it if you do not have a gallbladder. It can be very constipating for some. I use a lower dose than recommended because I'm fearful of severe constipation. I wouldn't suggest using it at the same time as amitriptyline because of the serious constipation potential.

Congrats on a change after 30 years!!

On 1/21/2025 at 10:04 PM, Jeffrey Roberts said:

@Nick0 that is really wonderful to hear! Good for you that you found something that has really worked for you.

25mg is the dose that helps me too without any troubling side effects. As I said in an earlier post, I have used it for 20+ years. Maybe I'll see something when I'm elderly in terms of long term side effects. Who knows. Every medication has issues.

Besides amitriptyline, I have used Viberzi and it works quite different. The results are almost instant. You cannot take it if you do not have a gallbladder. It can be very constipating for some. I use a lower dose than recommended because I'm fearful of severe constipation. I wouldn't suggest using it at the same time as amitriptyline because of the serious constipation potential.

Congrats on a change after 30 years!!

DR. Roberts so there is nothing in the natural remedies that has worked to help your IBS? So, there is no hope for those that cannot afford the medication? How do you reconcile knowing that you will suffer the side effects later on? 🥺

On 2/12/2025 at 12:15 AM, anamoon said:

DR. Roberts so there is nothing in the natural remedies that has worked to help your IBS? So, there is no hope for those that cannot afford the medication? How do you reconcile knowing that you will suffer the side effects later on? 🥺

Not a doctor, but thanks for the compliment.  

There are "natural" over-the-counter remedies that help some people depending on what is their more troubling symptoms.

For abdominal pain, peppermint oil is used.

For constipation, RetoraLAX (in Canada) or MiraLAX (US) is used

For diarrhea, loperamide is used.

IBSD and Amytriptyline -I have suffered from IBS on and off for some time however, in the last couple of years, due to a stressful family situation it had got significantly worst and was affecting my life/work. I tried a number of natural remedies and some prescribed drugs to no avail. Three months ago I was put on Amytripyline 10 mg one tablet taken in the evening and it has changed my life! I can now go out in the mornings without being on the loo for a couple of hours. I also watch what I eat and try to avoid gut irritants and follow the FODMAP diet which is very good. One general question, how long can I/should I stay on this drug? Found the forum helpful thank you

On 9/23/2025 at 3:56 AM, LynneW said:

One general question, how long can I/should I stay on this drug? Found the forum helpful thank you

Glad you have found the info here helpful.

You can stay on amitriptyline forever. There is no reason to stop it if it continues to help you. I have been using it daily for well over 25 years.