IBS Symptoms? Doctor Explains How Antidepressants Can Help

Dr Karan Raj reveals all.
Grace Cary via Getty Images

Now I know what you’re thinking: how on earth are antidepressants going to help with my irritable bowel syndrome (IBS)?

Well, you’ll be surprised (and possibly relieved if you suffer from symptoms) to know sometimes low doses of antidepressants can be prescribed for IBS, even if you’re not depressed.

“Antidepressants can reduce pain sensations, rectal hypersensitivity and other symptoms in IBS sufferers,” explains Pillcheck. “Research has shown that two main types of antidepressants (SSRIs and TCAs) help IBS symptoms.”

Irritable bowel syndrome (IBS) is a common condition affecting the digestive system, which causes symptoms such as stomach cramps, bloating, diarrhoea and constipation.

Unfortunately there’s no cure, which is why lifestyle changes and certain medicines are usually prescribed to try and help relieve symptoms.

So… how do antidepressants help?

In short: antidepressants can ease IBS symptoms because some of the chemicals that regulate a person’s mood can also regulate the digestive system.

It’s all about the gut-brain connection. Medical expert Dr Karan Raj took to TikTok to explain how your gut and brain health are connected, and suggested there is bidirectional feedback between the two.

The antidepressant works on the nerve cells, said Dr Karan Raj. “You’ve got a nervous system in the gut, so the antidepressant helps with IBS symptoms,” he added.

“Antidepressants are thought to work for IBS by affecting the levels of certain chemicals in the brain and gut, such as serotonin and norepinephrine, that can affect pain and mood,” according to private gastroenterologist Dr Ahmed Albusoda.

“These chemicals are involved in the gut-brain axis, which is the complex communication system between the brain and the digestive system.”

Antidepressants can affect gastrointestinal motility – so basically the muscle contractions that move food through your gastrointestinal tract – and also reduce abdominal pain.

Which antidepressants do people take for IBS?

Tricyclic antidepressants (TCAs) are the most commonly used to treat IBS.

The National Institute for Health and Care Excellence (NICE) recommends people are started on a low dose – for example, amitriptyline 5-10mg at night – with a view to slowly increasing the dose over time.

TCAs can help reduce pain and improve bowel function, according to Healthline.

Selective serotonin reuptake inhibitors (SSRIs) are more commonly used to treat depression and anxiety but could also be used to help reduce abdominal pain and improve bowel function.

Typically, SSRIs are considered for people who don’t respond to TCAs.

We need to talk about the risks…

There are a number of risks and side effects associated with taking antidepressants, especially when you’re not using them for their intended purpose.

Common side effects of SSRIs include:

  • Feeling agitated, shaky or anxious
  • Nausea/dizziness
  • Blurred vision
  • Low sex drive
  • Difficulty achieving orgasm during sex or masturbation
  • Erectile dysfunction
  • Indigestion/stomach aches
  • Insomnia
  • Loss of appetite
  • Headaches

Common side effects of TCAS include:

  • Dry mouth
  • Blurred vision
  • Constipation
  • Trouble urinating
  • Dizziness/drowsiness
  • Weight gain
  • Excessive night sweats
  • Heart rhythm problems.