title: The use of psychotropic drugs in irritable bowel syndrome.
abstract: BACKGROUND
  Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is manifested by chronic abdominal pain associated with irregular bowel movements. Although not life threatening, IBS is associated with impaired quality of life that ranges from mild to severe.
  
  
  METHODS
  The pathogenesis of IBS is not completely understood, but involves dysfunction of the "brain-gut axis" including peripheral visceral hypersensitivity and central maladaptive processing of visceral pain input. Stress and concomitant psychopathologies such as somatization, anxiety and depression are thought to play a major role in the development, clinical course and response to treatment. Psychopharmacological agents such as selective serotonin/serotonin-norepinephrine receptor antagonists, tricyclic antidepressants as well as other agents are commonly used in treating moderate to severe IBS. This review will provide the pathophysiological rationale for the use of psychopharmacological agents in IBS, review the main classes of drugs and evidence for their use in IBS and offer a practical approach to the use of these drugs.
  
  
  CONCLUSIONS
  Psychotropic drugs can play a pivotal role in the treatment of IBS patients, so doctors should be familiar with their use. Further research with these drugs is needed to solidify our current knowledge and increase our therapeutic options.
authors: Tel Aviv Medical Center, Gastroenterology, Tel Aviv, Israel. royd@tasmc.health.gov.il
authors: Roy
authors: R
authors: Dekel
authors: Douglas A
authors: DA
authors: Drossman
authors: Ami D
authors: AD
authors: Sperber
mesh_terms: D000818:Animals; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000473:pathology; D011600:Psychopharmacology; D011619:Psychotropic Drugs / Q000494:pharmacology* / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs