@socalgastrodoc: Disclaimer: this is NOT a reason to stop your SSRI (especially if you are taking it for anxiety or depression) please discuss with your healthcare team before making any changes to your treatment plan. Content for educational purposes only and does not constitute medical advice. Ever been put on an SSRI like Prozac or Lexapro for your IBS because you seemed "anxious"? Here’s what you need to know. IBS is not simply anxiety. The gut-brain connection is real and central to IBS, but that is not the same as your symptoms being "all in your head." There's real gut (and brain) physiology behind what you're experiencing. If your IBS is the diarrhea type (IBS-D), an SSRI can actually make symptoms worse. Serotonin increases gut motility, so a medication that alters serotonin levels can lead to more urgency and diarrhea, not less. That doesn't mean medications used for anxiety and depression have no place in IBS. Some are very helpful, but at different doses and for different reasons than treating depression or anxiety. For IBS-D, a low-dose tricyclic such as amitriptyline is more commonly used because it addresses different signaling pathways in addition to serotonin. We think of these as gut-brain medications, not antidepressants. The takeaway: your symptoms are real and physical, and they deserve a plan built around your gut, not just your mood. SSRIs aren't wrong for everyone with IBS (they can help if you also have anxiety or depression, or possibly if your IBS is more constipation-type), but they shouldn't be the automatic first choice for someone with IBS.

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Friday 04 September 2026 00:57:12 GMT