In diarrhoea-predominant IBS, which classes of antidepressants are used?

In diarrhoea-predominant IBS, which classes of antidepressants are used?

• A. Both SSRIs and TCAs
• B. SSRIs
• C. TCAs
• D. MAO inhibitors

Answer: (A)

In diarrhoea-predominant IBS, antidepressants are used to modulate pain and gut motility while also addressing mood symptoms that often accompany IBS. The two classes commonly employed are tricyclic antidepressants and selective serotonin reuptake inhibitors. Tricyclics help by slowing intestinal transit and reducing visceral pain, which can lessen diarrhoea and abdominal discomfort. They’re often chosen when diarrhea and pain are prominent, especially if there’s tolerability of potential daytime anticholinergic effects. Selective serotonin reuptake inhibitors are considered particularly when there are coexisting anxiety or depressive symptoms. They can influence central pain processing and the brain-gut axis, potentially improving overall IBS symptom burden even if their direct effects on stool consistency are variable. Monoamine oxidase inhibitors aren’t used routinely due to safety concerns and limited evidence in IBS.

In diarrhoea-predominant IBS, antidepressants are used to modulate pain and gut motility while also addressing mood symptoms that often accompany IBS. The two classes commonly employed are tricyclic antidepressants and selective serotonin reuptake inhibitors.

Tricyclics help by slowing intestinal transit and reducing visceral pain, which can lessen diarrhoea and abdominal discomfort. They’re often chosen when diarrhea and pain are prominent, especially if there’s tolerability of potential daytime anticholinergic effects.

Selective serotonin reuptake inhibitors are considered particularly when there are coexisting anxiety or depressive symptoms. They can influence central pain processing and the brain-gut axis, potentially improving overall IBS symptom burden even if their direct effects on stool consistency are variable.

Monoamine oxidase inhibitors aren’t used routinely due to safety concerns and limited evidence in IBS.