Relationship between use of selective serotonin reuptake inhibitors and irritable bowel syndrome: A population-based cohort study

Abstract

AIMTo investigate the relationship between selective serotonin reuptake inhibitor (SSRI) use and the subsequent development of irritable bowel syndrome (IBS).METHODSThis retrospective, observational, population-based cohort study collected data from Taiwan’s National Health Insurance Research Database. A total of 19653 patients newly using SSRIs and 78612 patients not using SSRIs, matched by age and sex at a ratio of 1:4, were enrolled in the study from January 1, 2000 to December 31, 2010. The patients were followed until IBS diagnosis, withdrawal from the National Health Insurance system, or the end of 2011. We analyzed the effects of SSRIs on the risk of subsequent IBS using Cox proportional hazards regression models.RESULTSA total of 236 patients in the SSRI cohort (incidence, 2.17/1000 person-years) and 478 patients in the comparison cohort (incidence, 1.04/1000 person-years) received a new diagnosis of IBS. The mean follow-up period from SSRI exposure to IBS diagnosis was 2.05 years. The incidence of IBS increased with advancing age. Patients with anxiety disorders had a significantly increased adjusted hazard ratio (aHR) of IBS (aHR = 1.33, 95%CI: 1.11-1.59, P = 0.002). After adjusting for sex, age, urbanization, family income, area of residence, occupation, the use of anti-psychotics and other comorbidities, the overall aHR in the SSRI cohort compared with that in the comparison cohort was 1.74 (95%CI: 1.44-2.10; P < 0.001). The cumulative incidence of IBS was higher in the SSRI cohort than in the non-SSRI cohort (log-rank test, P < 0.001).CONCLUSIONSSRI users show an increased risk of subsequent diagnosis of IBS in Taiwan.

Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management

“…Other SSRIs have been studied with diverse results. Paroxetine enhanced patients’ perception of well-being, but did not ameliorate abdominal symptoms [ 78 ]. In contrast, some studies found that fluoxetine improves abdominal symptoms and stool frequency in IBS-C patients [ 79 ].…”

Comparison of the safety and efficacy of the on‐demand use of sertraline, dapoxetine, and daily use of sertraline in the treatment of patients with lifelong premature ejaculation: A prospective randomised study

“…Akasheh et al also reported that the daily use of sertraline significantly decreased sperm concentration and impaired sperm transportation (Akasheh et al, 2014). TA B L E 1 Demographic data syndrome (Lin et al, 2017), and an increased risk of dementia in older patients (Gray & Hanlon, 2016). We suggest that the risk of such side effects increases as the cumulative SSRI dose and duration of SSRI use increase.…”

“…We suggest that the risk of such side effects increases as the cumulative SSRI dose and duration of SSRI use increase. Due to these potential risks and well-known associated side effects, decreasing the cumulative dosage of SSRIs may be a viable solution (Burcu et al, 2017;Gray & Hanlon, 2016;Lin et al, 2017). For these reasons, it has been suggested that alternative SSRI uses-such as the OD use of short-acting or long-acting SSRIscan be detract from these adverse effects.…”

Buspirone in the management of refractory irritable bowel syndrome

“…[ 31 ] Conversely, Lin et al's population-based retrospective observational study found an increased adjusted hazard ratio of BIS in patients with anxiety disorders and individuals who were prescribed SSRIs. [ 32 ] Furthermore, a recent analysis of 18 randomized clinical trials found a favorable outcome for TCAs, but not SSRIs in addressing IBS symptoms. Limitations such as lower placebo rates, data analysis and reporting, and publication bias must be taken into consideration when interpreting these findings.…”