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Irritable bowel syndrome - Management
Which antidepressant should I prescribe?
- Tricyclic antidepressants (TCAs) are the antidepressants of choice in the management of irritable bowel syndrome (IBS).
- Most studies of TCAs in IBS have used amitriptyline or trimipramine.
- CKS therefore recommends the use of either of these TCAs in the management of IBS.
- Neither amitriptyline or trimipramine are licensed for the management of IBS.
- Selective serotonin reuptake inhibitors (SSRIs) should be considered for people with IBS only if TCAs have been shown to be ineffective.
- Citalopram, fluoxetine, and paroxetine have been studied in the management of IBS.
- CKS therefore recommends the use of one of these three SSRIs in the management of IBS.
- These SSRIs are not licensed for the management of IBS.
[National Collaborating Centre for Nursing and Supportive Care, 2008]
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