Psychotropic agents in irritable bowel syndrome.

The use of antidepressants to treat patients with irritable bowel syndrome (IBS) has been extended in recent years because of their possible neuromodulatory and analgesic effects, generally in doses that do not have antidepressant effects. There seems to be sufficient evidence to support the recommendation that psychotropic agents may be effective in two clinical scenarios that are not mutually exclusive. The first is in patients with IBS who have pain and related symptoms that are unresponsive to medical therapy. The second is in patients with IBS who have concomitant psychologic dysfunction. This article reviews the evidence to support these recommendations and guidelines, which may be used to optimize medical management in these patients.