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Irritable Bowel Syndrome: Can Antidepressants Help IBS in Teens?

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Updated October 06, 2008

Question: Irritable Bowel Syndrome: Can Antidepressants Help IBS in Teens?

From a reader:My 13-year-old son has irritable bowel syndrome (IBS) and takes medication for diarrhea and pain. My 17-year-old nephew also has the condition, and his doctor put him on a medication to treat depression. Should my son also take this medication?

Answer:

I’m sorry to hear about your son’s condition. Irritable bowel syndrome (IBS) can be a frustrating and difficult condition to treat. There have been reports, in the medical journals, that some medications in a class of drugs known as tricyclic antidepressants are useful for the treatment of IBS in teenagers.

The most commonly used medication from this class of drugs used to treat IBS is amitriptyline, which was originally sold under the brand name Elavil.

A low dose of amitriptyline can improve the quality of life for teenagers suffering from IBS, according to researchers from the Mattel Children's Hospital in Los Angeles. IBS, which affects 6% of middle school kids and 14% of high school kids in the United States, can cause abdominal discomfort along with constipation, diarrhea or both. There is no cure for the condition, but available treatments may help diminish the symptoms.

The results of the study showed that the teens who received amitriptyline were more likely to have:

  • an improvement in their overall quality of life
  • a decrease in diarrhea from their IBS
  • a reduction in abdominal pain

The researchers concluded that amitriptyline should be a treatment option for adolescents with IBS.

Martha, you may want to talk with your child's pediatrician or family physician to find out if the use of amitriptyline is appropriate for your son.

You should also be aware that some parents of teens with IBS have been reluctant to allow their kids to use an antidepressant medication, because of a recent black box warning from the U.S. Food and Drug Administration (FDA) about the increased risks of suicidal thinking and behavior in teenagers and young adults. The dose of amitriptyline used in the research study, however, was much lower than the dose usually recommended for the treatment of depression.

More information:

Source:
Bahar R, Collins B, Steinmetz B, Ament M. “Double-blind Placebo-Controlled Trial of Amitriptyline for the Treatment of Irritable Bowel Syndrome in AdolescentsThe Journal of Pediatrics 2008 152:685-689.

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