Video: Antidepressants for IBS?
The use of the antidepressant drug class in low doses for treatment of IBS symptoms is not linked to depression, but rather likely to effects on the brain and the gut. Antidepressant medications can reduce the intensity of pain signals going from gut to brain.
When symptoms are more painful and reduce health related qualify of life, low-dose tricyclic antidepressants [e.g., amitriptyline (Elavil), desipramine (Nopramin)] have been shown to be effective in treating IBS, particularly in those with mainly diarrhea. They have central nervous system (CNS) and peripheral (gut) effects that relieve abdominal pain and reduce diarrhea.
Some of the newer serotonin-norepinephrine reuptake inhibitors [SNRIs, e.g., duloxetine (Cymbalta)] have fewer side effects and may be helpful for IBS symptoms but are not yet proven.
At times selective serotonin reuptake inhibitors (SSRIs) can help reduce anxiety associated with IBS and can help reduce symptoms of constipation.
Be aware that the effectiveness of various agents differs between individuals and a medication regimen must be carefully chosen by the patient and his or her physician.
Adapted from IFFGD publication #101b revised and updated by: Douglas A. Drossman, MD, Drossman Gastroenterology PLLC, Chapel Hill, NC.