Antidepressants

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Pain that is resistant to antispasmodics may respond to treatment with low doses of antidepressants. This may be partly due to the alleviation of an underlying depression and partly because of a direct effect on pain pathways in the gut. Anxiety and depression can make people more sensitive to pain and can upset the bowels.

There are two classes of drugs.

Tricyclic antidepressants

	Generic name	Brand name
	Amitryptyline	Tryptizol
	Nortryptyline	Doxepin
	Dothiepin Hydrochloride	Prothiadin

*Tricylic antidepressants tend to make constipation slightly worse.
Selective Serotonin Reuptake Inbibitors (SSRIs)

Selective Serotonin Reuptake Inbibitors (SSRIs)

	Generic name	Brand name
	Fluoxetine	Prozac
	Sertraline	Lustral
	Paroxetine	Seroxat
	Citalopram	Cipramil

*SSRIs can make the bowels more loose and may be more useful in people with constipation.
NB: Antidepressants can only be obtained on prescription

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