Antidepressants could be a beneficial therapy for patients with inflammatory bowel disease for symptoms beyond anxiety and depression, according to research published in Inflammatory Bowel Diseases.
Marie Skov Kristensen, MSc, RN, of the National Institute of Public Health at the University of Southern Denmark, and colleagues wrote that psychiatric comorbidity can modify disease course in patients with IBD.
“Apart from improving mood, it is observed that the anti-inflammatory properties of antidepressants may influence the inflammatory response directly,” they wrote. “Other research suggests a bidirectional relationship between IBD activity and psychological disorders, that is, the ‘brain-gut axis’, wherein relief of depression and anxiety symptoms by the use of antidepressants potentially affects gut health.”
Researchers studied the impact of antidepressants on disease course in IBD by analyzing data from the Danish National Patients Register of patients diagnosed with Crohn’s disease or ulcerative colitis between 2000 and 2007 (n = 42,890; 69.5% UC; 30.5% CD). They examined antidepressant use and used health care and drug use to measure disease activity.
Investigators found that those who used antidepressants after diagnosis had a lower incidence rate of disease activity compared with non-users in both CD (IRR = 0.75; 95% CI, 0.68–0.82) and UC (IRR = 0.9; 95% CI, 0.84–0.95). The rate was even lower among patients who had never taken antidepressants before their diagnosis for CD (IRR = 0.51; 95% CI, 0.43–0.62) or UC (IRR = 0.67; 95% CI, 0.59–0.75).
Kristensen and colleagues wrote that their findings show that antidepressants could be an important adjuvant treatment for IBD, and more trials are needed to confirm their impact on disease course.
“Despite the high prevalence of anxiety and depression, it is found that IBD patients often do not receive appropriate psychiatric treatment,” they wrote. “A holistic approach should be applied when screening IBD patients systematically for symptoms of anxiety and depression.” – by Alex Young
Disclosures: Kristensen reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.