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Xanax mechanism of action for IBS

ryand123

Bluelighter
Joined
Jul 8, 2011
Messages
206
I have severe IBS-D (going to the bathroom 10+ times a day) and have been perscribed 1mg xanax 3 times daily. It has helpes significantly. Upon doing countless hours of research I still dont understand exactly what is helping so much. I know that as an allosteric modulater of GABA it inhibits stress in the body causing relaxation, but is is also a CCK antagonist in the gut. Does anybody know which one is more likely to be helping my condition? Or is it just a combination of both? Very curious as i dont know too much about cck antagonism.
 
A doctor prescribed you xanax for IBS? That seems very out of the ordinary, and horribly irresponsible. I imagine anxiety could worsen your condition, but CCK antagonism is surely more directly responsible for any benefits. There are other CCK antagonists available without the risk of dependence, and ways to treat IBS through other modes of action with more data behind them.
 
I have severe IBS-D (going to the bathroom 10+ times a day) and have been perscribed 1mg xanax 3 times daily. It has helpes significantly. Upon doing countless hours of research I still dont understand exactly what is helping so much. I know that as an allosteric modulater of GABA it inhibits stress in the body causing relaxation, but is is also a CCK antagonist in the gut. Does anybody know which one is more likely to be helping my condition? Or is it just a combination of both? Very curious as i dont know too much about cck antagonism.

Which symptoms is it helping with?
 
^forgot to add. Any stressful events no matter how large tend to exacerbate my IBS and the xanax has helped me cope with stressful situations alot better and therefore eased my pain in this way as well.
 
It is helping with the bloating, diarrhea, constant feeling of never completely evacuating my bowels, cramps, overall feeling of pain in abdomen. The xanax was a last line resort but it has helped significantly over the past 3 months. Very grateful for my doctor as he was very understanding and has been a lifesaver. My IBS has affected all aspects of my life, career, personal, love life, ect. He hasnt been irresponsible at all IMO.
 
The problem with benzodiazepines is that tolerance to them raises relatively quickly, especially for short-acting ones like alprazolam (Xanax), and the risk for physical dependence even after a few months of regular use is very high. I find alprazolam to be particularly inconspicuous among benzodiazepines as it doesn't produce much sedation or amnesia at therapeutic doses, when you suffer from anxiety, all it does is make you feel like a normal person, you only realize how strongly it works on you when you've been taking it for some time regularly and then skip a dose.

Going through a benzodiazepine withdrawal is a no-joke, it is on par with the most horrible opioid withdrawals and with long-term use residual symptoms of withdrawal can linger for months or even years after quitting in extreme cases. For all the reasons mentioned benzodiazepines should only be prescribed for anxiety or insomnia when there is absolutely no alternative and at the lowest dose that works, then the treatment should be as short as possible with gradual dose reduction before stopping them. Have you come to this dose starting from a lower one first? I do hope your doctor is well informed about benzodiazepines, their mode of action, and how tapering off should be handled. Falling into a benzodiazepine addiction unknowingly combined with a doctor who is eager to prescribe as many pills as you ask and is completely unaware of the risks is a tragedy waiting to unfold. And there are still many doctors out there who freely prescribe benzos with no idea what they're doing.
 
As others have said, be aware of benzo addiction/dependence. If long term benzo use is going to be a thing regardless, a very long acting benzo would be preferred rather than a shorter acting benzo, use of which will not produce as stable drug levels. Stable drug levels are preferred with regards to slowing down dependence/tolerance.

If the reason why the benzos are working has to do with the benzos affecting the GI tract directly then theoretically you would want a benzo that has a high periphery > CNS ratio, because if benzos are working primarily in the periphery for you, benzos in the CNS would only lead to dependence et cetera.

GABA (benzos) is known to play a role in peristalsis rather directly, but the CNS/brain certainly modulate GI tract function. There is also the enteric nervous system.

CY
 
I am very familiar with benzos and have used them for quite a while (6 years or so) . I have a panic disorder and have been on benzos on and off for a few months here and there for the panic before doing a dr regimented taper and coming off them. It was actually during these periods that i noticed how much of an effect it had on my IBS. After trying many other approaches for my condition we decided to stick with the alprazolam. It was originally 1mg in the morning and 1mg at night but midday the symptoms would come back so we added 1mg in the middle of the day. Longer acting benzos such as clonazepam and chlordiazepoxide havent been too effective for some reason. Although i havent tried too many other benzos for this purpose. The alprazolam has been the most beneficial so far, and at the dosages i am taking i get very little CNS activity (not foggy, sleepy, ect), and my stomach issues are so much better. This is why i was thinking it may be due to CCK antagonism rather than GABA modulation. I would much rather take something with little to no dependence liability but at the moment this is working perfect for me and i have been on it for this issue for a few months now with practically no tolerance to the beneficial GI effects it provides.
 
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