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Antidepressants and IBD

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Posted 8/16/2019 10:59 PM (GMT -6)
about a year ago, I was casually discussing that I had UC with a friend. And he mentioned that his sister had Crohn's, and after a long and tough struggle, doctors found that it was Prozac (maybe Zoloft?) that was the key to helping her get better. I don't know specifics (e.g. whether it helped her into remission or maintained it or other meds she was on) but it was something I just now thought to investigate. I didn't think much about it then.

And I just found this study done last year:
https://www.ncbi.nlm.nih.gov/pubmed/30551218

This is the longer article explaining its findings: https://www.medpagetoday.com/gastroenterology/inflammatoryboweldisease/77004

It looks like antidepressants can be quite beneficial for some patients. I don't want to summarize here as these studies are complicated but the moral of the story is that:

From study:
"In this nationwide study, antidepressant use was found to be beneficial on the disease course among patients with UC and CD, particularly in patients with no use of antidepressants before IBD onset."

From article:
"Kristensen and colleagues noted that in terms of potential pathways, antidepressants affect levels of pro-inflammatory cytokines such as interleukin and TNF, known to be involved in the pathogenesis of IBD. "Hence, decreased levels of pro-inflammatory cytokines may explain the observed favorable influence on the course of IBD," the team wrote, adding that antidepressants also positively affect brain-gut interaction."

I find it really validates what a lot of us here talk about: the mind/gut connection. And, at least for me, I get very frustrated with doctors who rarely talk about this psychological connection (and diet for that matter). Anyways, this study is super recent--just last year--so it's worth reading, if only for a different take.

Prozac, here I come?
Posted 8/17/2019 8:43 AM (GMT -6)
Last year I started taking Bupropion 300 mg every day I was in a bad flare I was also doing Briggs protocol I think the bupropion got me out of the flare wasnt in remission but I was doing much better I stopped taking bupropion 3 to 4 months ago and I stopped the Briggs protocol I was told bupropion acts like remicade in a way well if I ever flare like that again ill try bupropion again now im just taking lialda canasa and uceris foam when things seem to get worse for now I fast for 16 hours a day and do the ibd diet seems to be working for me my goal is to get down to taking lialda 2 pills a day and canasa 2 to 3 times a week these meds are so expensive when you have crappy insurance try bupropion first couple of weeks on it is tough but after that you will be good
Posted 8/17/2019 8:45 AM (GMT -6)
I’ve often wondered if an antidepressant would help me since I have frequent periods of intense stress that I’m constantly fearing will lead to a flare.
Posted 8/17/2019 11:26 AM (GMT -6)
Most antidepressants have horrible side effects (say goodbye to your sex drive or ability to orgasm if you take Prozac or any other SSRI), with the exception of Wellbutrin and Remeron (get ready to sleep a lot on Remeron and possibly gain a ton of weight though). Cymbalta made me flare within days of taking it. Most antidepressants arent any more effective than placebo. You can find that research if you Google it.
Posted 8/17/2019 1:09 PM (GMT -6)
This has been discussed in the past but I can't recall the context. I remember Wellbutrin having some research in relation to IBD.

Sara I am interested in your comments about cymbalta. I take it for pain and it caused diarrhea for two weeks when I first started, no flare. I do regret starting it, in a way as I feel like a drug addict. Miss a dose and I get sickly feeling. Consider yourself lucky in that regard. I have had sexual partners who take ssri and they orgasm just fine. Also many extended family who take Prozac and consider it a life saving drug. Antidepressants are not all bad.
Posted 8/18/2019 7:05 AM (GMT -6)
I personally think starting Lexapro is what helped my gut the most. I was so afraid to take it due to possible gut problems but it helped slow things down. Also I am a very anxious person and the Lexapro does stop the panic attacks. I think it helps to keep me calm and therefore has a positive effect on my gut. I gained some weight but I spent 3 weeks in Italy this spring eating a ton of food. Last years trip was cancelled due to flare. Lexapro did not have any placebo effect at all because I was terrified to take it and was expecting more diarrhea etc. it had the opposite effect. I hate drugs but I popped my cherry after getting IBD and having to take so many drugs to combat it.
Posted 8/19/2019 7:51 AM (GMT -6)
Hi Sara14,

You wrote:

"Most antidepressants arent any more effective than placebo. You can find that research if you Google it."

Can you provide link on the research?

I have found this study:

https://www.thelancet.com/journals/lancet/article/piis0140-6736(17)32802-7/fulltext

The outcome of this study is unequivocal: antidepressants ARE effective!
Posted 8/19/2019 11:11 AM (GMT -6)

Oligodar said...
Hi Sara14,

You wrote:

"Most antidepressants arent any more effective than placebo. You can find that research if you Google it."

Can you provide link on the research?

I have found this study:

https://www.thelancet.com/journals/lancet/article/piis0140-6736(17)32802-7/fulltext

The outcome of this study is unequivocal: antidepressants ARE effective!

Yep, here is one: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/

Another, from a Harvard researcher: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

And a great article that provides an overview: https://www.newsweek.com/why-antidepressants-are-no-better-placebos-71111

I haven't had time to read through the entire link you shared yet, but I will do so later. I did see they noted in the beginning that 82% of the 522 trials they looked at were rated as having a moderate-to-high risk of bias. I also saw that 409 (78%) of 522 studies they reviewed were funded by pharmaceutical companies. The only population that I've seen in my previous research on this who MAY have been helped with antidepressants more than placebo is a very small group of people with the most severe depression.

Anyway, I don't want to hijack David's post. I will say that exercise works wonders for my anxiety/depression. Meditation also helps.
Posted 8/19/2019 11:14 AM (GMT -6)

Uniform Charlie said...
This has been discussed in the past but I can't recall the context. I remember Wellbutrin having some research in relation to IBD.

Sara I am interested in your comments about cymbalta. I take it for pain and it caused diarrhea for two weeks when I first started, no flare. I do regret starting it, in a way as I feel like a drug addict. Miss a dose and I get sickly feeling. Consider yourself lucky in that regard. I have had sexual partners who take ssri and they orgasm just fine. Also many extended family who take Prozac and consider it a life saving drug. Antidepressants are not all bad.

Well, your sexual partners aren't the norm. Yeah, Cymbalta made me flare within days of starting it. I discontinued it. Was on it less than a week. Glad it helps you. I know what you mean about the feeling like a drug addict bit. I did take Wellbutrin to quit smoking and had no ill effects from that, other than crazy dreams all night long that made me never feel rested. It did help with nicotine cravings.
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