Antidepressants for irritable bowel syndrome: Figure 1
Open accessAbstract
Systematic reports of antidepressant use in irritable bowel syndrome (IBS) first appeared in the medical literature three decades ago. Recent meta-analyses of the cumulative controlled experience confirm the efficacy of antidepressants in IBS and other functional gastrointestinal disorders: only 3–4 patients require treatment to demonstrate a benefit over placebo—numbers indicating a solid treatment effect.1–3 Although many of the earlier reports would be considered scientifically flawed by today’s standards, the effects are consistent across studies. Odds ratios of treatment over placebo for primary study outcome, global (or syndromic) response, and pain exceeded 4.0 for each determination in one analysis, and the effect sizes of antidepressant treatment on continuous outcome measures were large.3 These observations in conjunction with reported open label experience and general clinical success have given antidepressants an important position in the therapeutic armamentarium for IBS.4 Most studies have employed tricyclic antidepressants (TCAs), medications that appear to have benefits not necessarily shared across the antidepressant class. Daily dosages of TCAs (25–125 mg/day) that are below the psychiatric range for antidepressant effect typically are effective in IBS, producing at least a moderate response in more than 85% of patients in open label use.5 With the TCAs, onset of action is rapid, effects appear sustained without tachyphylaxis, and the benefits are unrelated …
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A study of inflammatory bowel disease patients in clinical remission found that Rome II symptoms correlated with increased calprotectin, suggesting that occult inflammation may drive symptoms.
“A study evaluating IBD patients in clinical remission noted that Rome II symptoms correlated with increased calprotectin suggesting that occult inflammation may be driving these symptoms.3”
From Tricyclic Antidepressants for Management of Residual Symptoms in Inflammatory Bowel Disease (2014) · cites this paper as [3]
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- Authors
- Clouse, R. E.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Clouse, R E
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2003-04
- Volume
- 52
- Issue
- 4
- Pages
- 598-599
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1773590
- OpenAlex
- W2118134081
- Cited by
- 74
- References
- 12
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 4 · 2016: 2 · 2015: 1 · 2014: 6 · 2013: 2 · 2012: 2
- FWCI
- 5.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- antidepressants, irritable bowel syndrome, tricyclic antidepressants, functional gastrointestinal disorders, treatment efficacy, placebo response, analgesia
- MeSH terms
- Algorithms, Antidepressive Agents, Colonic Diseases, Functional, Drug Administration Schedule, Humans
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