Antidepressant may help manage irritable bowel syndrome symptoms

In the journals

Amitriptyline, a tricyclic antidepressant also used to treat nerve pain, may be one of the best pharmacologic choices to help improve symptoms of irritable bowel syndrome (IBS).

IBS causes abdominal pain and changes to bowel movements, with symptoms fluctuating in severity over time. IBS has no cure, and standard treatments like dietary and lifestyle changes and taking antispasmodic or antidiarrheal medications yield varying benefits.

In a study published Nov. 11, 2023, in The Lancet, 463 people with IBS took either amitriptyline (10 to 30 milligrams based on the severity of each person's symptoms) or a placebo every day for six months. Afterward, people who took amitriptyline were almost twice as likely as those taking a placebo to report an overall improvement in their symptoms and had significantly lower IBS severity. It's believed amitriptyline helps by increasing people's threshold for IBS pain and discomfort.

The researchers suggested that doctors should consider low-dose amitriptyline for managing IBS when dietary and other lifestyle changes are not sufficient.