How antidepressants work in IBS
Antidepressants can:
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Reduce visceral pain sensitivity
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Calm overactive gut nerves
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Improve gut motility
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Reduce stress-related symptom flares
They are usually prescribed at much lower doses than those used for depression.
Types of antidepressants used in IBS
Tricyclic antidepressants (TCAs)
Often used for IBS with diarrhoea or pain.
Examples include:
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Amitriptyline
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Nortriptyline
Benefits:
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Reduce abdominal pain
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Slow bowel transit
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Improve sleep quality
WARNING! DO NOT TAKE MEDICINE UNLESS RECOMMENDED BY YOUR HEALTHCARE SPECIALIST!
Selective serotonin reuptake inhibitors (SSRIs)
More commonly used for IBS with constipation or anxiety features.
Examples include:
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Sertraline
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Citalopram
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Fluoxetine
Benefits:
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Improve gut–brain signalling
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May speed up bowel movements
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Help with anxiety-related symptoms
SNRIs and other neuromodulators
Used in selected cases where pain is severe or persistent
WARNING! DO NOT TAKE MEDICINE UNLESS RECOMMENDED BY YOUR HEALTHCARE SPECIALIST!
Are antidepressants safe for IBS?
When prescribed by a specialist, antidepressants are safe and well tolerated for IBS.
Possible side effects may include:
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Dry mouth
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Drowsiness
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Mild nausea
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Temporary changes in bowel habits
Most side effects improve over time and doses are adjusted carefully.
Who may benefit most?
Antidepressants may be helpful if:
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Pain is a dominant symptom
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IBS symptoms persist despite diet changes
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Stress worsens gut symptoms
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There is coexisting anxiety or sleep disturbance
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IBS significantly affects quality of life
What antidepressants do not do
It is important to understand that antidepressants:
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Do not cure IBS
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Do not treat depression unless prescribed at higher doses
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Work best as part of a wider treatment plan
They are often combined with dietary advice, gut-directed therapies, and lifestyle changes.