Serotonin modulators, dosing

Tricyclic antidepressants (TCAs) such as amitriptyline and doxepin have been used with some success in the treatment of IBS-related pain (Table 18-5). They modulate pain principally through their effect on neurotransmitter reuptake, especially norepinephrine and serotonin. Their helpfulness in functional gastrointestinal disorders seems independent of mood-altering effects normally associated with these agents. Low-dose TCAs (e.g., amitriptyline, desipramine, or doxepin 10 to 25 mg daily) may help patients with IBS who predominantly experience diarrhea or pain. 

Ibogaine can affect several aspects of serotonergic transmission at concentrations that are readily achieved in the brain following pharmacologically relevant doses [reviewed by Sershen et al. (I8S)]. Because multiple serotonin receptor subtypes, as well as serotonin re-uptake, are modulated by ibogaine, it is not surprising that the effects of this alkaloid on steady-... 

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