Which medications in the drug class Tricyclic Antidepressants are used in the treatment of Irritable Bowel Syndrome (IBS)?

Updated: Dec 11, 2019
  • Author: Jenifer K Lehrer, MD; Chief Editor: BS Anand, MD  more...
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Tricyclic Antidepressants

Tricyclic antidepressants have both antidepressive and analgesic properties. Agents such as imipramine and amitriptyline are efficacious in treating symptoms of irritable bowel syndrome. The use of tricyclic antidepressants in irritable bowel syndrome is off label.

Imipramine (Tofranil)

Imipramine increases pain threshold in the gut, thereby providing a visceral analgesic effect. It prolongs oral-cecal transit time; reduces abdominal pain, mucorrhea, and stool frequency; and increases global well-being variably. It is effective in irritable bowel syndrome in doses that are subtherapeutic for antidepressive actions, suggesting an independent mechanism of action in this disorder.

Amitriptyline (Elavil)

Like imipramine, amitriptyline provides a visceral analgesic effect at doses subtherapeutic for antidepressive actions. It also prolongs oral-cecal transit time, reduces abdominal pain, mucorrhea, and stool frequency, and increases global well-being variably.

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