10 replies to this topic

[Axmann8]

To begin:

I had abdominal pain-predominant IBS for years, and I believe that it was due to altered sertonin transmission in my gut (this became apparent when going on lexapro improved my mood but caused terrible abdominal pain).

 

Another thing, I take nootropics frequently. Nothing heavy, mostly things like racetams, citicoline, etc.

Which antidepressant would be most ideal under these circumstances? I'd like to try tianeptine, but it's not available for prescription in the US and I don't want to have to get into group buys and things like that for it.

The four I'm currently considering are vortioxetine (Brintellix), clomipramine (Anafranil), Nortriptyline (Pamelor), or duloxetine (Cymbalta). I want the one that's going to cause the least cognitive impairment and sedation.

[golden1]

I'm trying out taking tianeptine specifically for IBS, it works decent, certainly doesn't make it worse for me. You can just order it online. nootropicsdepot

Edited by golden1, 13 August 2014 - 12:14 AM.

[Gorthaur]

I second the recommendation of tianeptine for IBS. You might need a slightly higher dosage than the standard of 37.5 mg a day recommended for depression. Nootropics Depot is my source as well, but you can also use NewMind, Ceretropic, or ebay.

[Axmann8]

Would it be worth trying to get my hands on Stablon or Coaxil or no? Also, what would the most cost-effective source be? How long would a 3-gram supply of tianeptine last?

Also, my doctor recommended vortioxetine (Brintellix). It has some 5-HT3 antagonism, so I was wondering if that might be beneficial for someone with sensitive gut serotonin receptors?

Edited by Axmann8, 13 August 2014 - 03:31 AM.

[Axmann8]

Bump

[golden1]

Would it be worth trying to get my hands on Stablon or Coaxil or no? Also, what would the most cost-effective source be? How long would a 3-gram supply of tianeptine last?

Also, my doctor recommended vortioxetine (Brintellix). It has some 5-HT3 antagonism, so I was wondering if that might be beneficial for someone with sensitive gut serotonin receptors?

 

I can only say that tianeptine doesn't seem to negatively effect my cognition at all, so I would go with it over another antidepressant. In fact it doesn't seem to make me feel much different at all, just less stressed. When I tried an SSRI it was noticeable and weird, but who knows if that was just abnormal.

 

5-ht3 antagonism should be helpful though yes. See: https://en.wikipedia...rome#Medication

 

heres a study on tianeptine vs. amitriptiline for IBS:

http://www.ncbi.nlm....pubmed/22679908

"At week 4, non-inferiority of the tianeptine group to the amitriptyline group (treatment difference -15.1%; 95% CI -26.6% to -3.8%) was shown, with 81.1% (99 of 122 patients) of the patients in the tianeptine group and 66.0% (70 of 106 patients) in the amitriptyline group reporting global relief of IBS symptoms. The secondary endpoints also demonstrated non-inferiority of the tianeptine group to the amitriptyline group. Adverse events such as dry mouth and constipation were significantly lower in the tianeptine group than the amitriptyline group (P<0.05)."

 

I use ~20mg twice a day. So.. 25days per gram, 75 days with 3 grams. But maybe just get one gram to see if it works for you. Its pretty cheap anyway I guess though.

[Axmann8]

A little update...

Escitalopram improved my mood quite a bit; I think I'm going to have to come to terms with being depressed.

I tried tianeptine 12.5 mg t.i.d., but didn't really seem to notice any difference.

Are my only choices taking escitalopram and having stomach pain or being off it and being depressed? :( Should I maybe try adding a 5-HT3 antagonist?

[Plasticperson]

sbo probiotics and resistant starch.. especially considering the ibs symptoms 

[Axmann8]

sbo probiotics and resistant starch.. especially considering the ibs symptoms 

 

I'm 99% certain that my IBS is caused by altered serotonin regulation, not bacterial issues. It's mostly abdominal pain.

Edited by Axmann8, 20 August 2014 - 03:42 AM.

[StevesPetRat]

Colostrum (up to 15 g daily, you have to research to find a good source) and butyrate (at least while you build up your RS dose) are 2 amazing gut supplements.

You're not alone with the serotonin gut pain thing. If I take too much 5-HTP, it feels like my colon is going to simply implode, sucking in a few vertebrae and maybe part of my leg with it.

Gut bacteria are almost certainly responsible, though, as according to the APA they "manufacture about 95 percent of the body's supply of serotonin". Now, I'm not certain they've got it right (95%?!), but they definitely, at a minimum, majorly influence the release of serotonin from EC cells.

[Flex]

evodiamine would be an alternative to Tianetpine, in addition it increases the SERT expression.