See information below on IBS and this treatment. To create a Treatment Checklist, go to the bottom of the screen and enter your information in the four sections: 1) past or present use, 2) frequency and duration, 3) did this treatment work?, and 4) significant side effects. To see the next treatment either click on the treatment list at the bottom of the screen or click ‘Save and Continue to Next Treatment.’ Click ‘Submit (Done)’ to generate a list to print or email, to discuss with your physician.

Tricyclic Antidepressants (e.g. amitriptyline (Elavil), desipramine (Norpramin), nortriptyline (Pamelor))

How it works:
Acts on nerves within the gastrointestinal tract, spinal cord, and brain to improve abdominal and bowel symptoms.
Which symptoms it helps:
Overall IBS symptoms including the abdominal pain. TCAs can also slow down the gut transit and improve symptoms of diarrhea.  
How long it takes to see a benefit:
2-4 weeks.
Who may benefit:
All IBS subgroups, anti-diarrheal effects make TCAs particularly attractive for IBS-D.
FDA approved:
N/A
Dosage:
10-75 mg, Initiate at low dose and increase the dose based on response and tolerability every couple of weeks.
Special considerations or risks:
Dosage for IBS are usually lower than anti-depressive range. When discontinuing TCAs, gradually taper the dose over 2 to 4 weeks to minimize withdrawal symptoms.
Most common side effects:
Drowsiness, dry mouth, palpitations, blurred vision, and weight gain.

Recommendation:
ACG recommends TCAs for overall symptom improvement in IBS patients.

Recommendation:
STRONG
Quality of Evidence:
HIGH
Level of Evidence:
√+
Past and Present Use Frequency and Duration Did this treatment work? Significant Side Effects
Past Use   Present Use   Yes   No   N/A