This article discusses how antidepressants help treat IBS and which ones are effective.
Antidepressants have been shown to affect many aspects of the body, especially the digestive system.
Neurotransmitters are chemical messengers that help nerve cells communicate with each other.
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They include acetylcholine, serotonin, norepinephrine, and dopamine.
Antidepressants are used to modify the actions of these neurotransmitters.
Recommendations and Use
Healthcare providers may prescribe an antidepressant to someone with IBS.
This is considered an “off-label” use of the drug.
No antidepressant has been approved by the U.S. Food and Drug Administration (FDA) as an IBS treatment.
Antidepressants are used to control symptoms of IBS.
They are not a cure for IBS.
Tricyclic Antidepressants
Tricyclic antidepressants are often prescribed for treating depression.They have well-documented anti-pain and gut-slowing qualities.
This seems due to their actions on the neurotransmitters serotonin, dopamine, and norepinephrine.
This slowing down of gut motility makes TCAs better suited for the treatment of diarrhea-predominant IBS (IBS-D).
Because they only target serotonin, SSRIs generally have fewer side effects than TCAs.
Side effects are common but often go away as your body adjusts to the medication.
However, the 2021 ACG guidelines say SSRIs are ineffective.
People react differently to medications and you may tolerate one jot down of SSRI better than another.
Stopping antidepressants abruptly can cause serious side effects.
5-HT3 for Depression
Researchers have looked at medications that target specific serotonin receptors, or 5-HT3 receptors.
Receptors receive chemical messages from neurotransmitters like serotonin.
The controversial IBS medication Lotronex (alosetron hydrochloride) is a 5-HT3 receptor antagonist.
The FDA has imposed strict limits for prescribing it.
There is one 5-HT3 antidepressant, Remeron (mirtazapine).
Data is limited as to the effectiveness of Remeron for IBS and therefore it may be less commonly prescribed.
Summary
Antidepressants may be prescribed for IBS because of their effects on the digestive system.
A Word From Verywell
Living with IBS can be challenging, and the symptoms can be unpredictable.
2021 Nov 23;30(4):517-525. doi:10.15403/jgld-4090
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