Antidepressants for irritable bowel syndrome

Clouse, R.E.
April 2003
Gut;Apr2003, Vol. 52 Issue 4, p598
Academic Journal
• Antidepressants are effective in managing lBS symptoms. • TCAs and contemporary antidepressants may reduce lBS'symptoms through different mechanisms. • Gradual TCA dosage escalation from a Iow starting point is appropriate as the initial antidepressant trial for lBS patients in whom the adverse effect profile is considered acceptable for symptom severity. • Presence of an active anxiety or affective disorder or features of somatisation disorder influences the treatment algorithm. • Long term antidepressant treatment may be required to suppress lBS symptoms; vigilance for adverse effects and ongoing weighing of treatment benefits against adverse effects is necessary to optimise chronic management.


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