WEDNESDAY, April 8, 2026 (HealthDay News) -- For patients with irritable bowel syndrome (IBS), antidepressants and certain antidiarrheal medications are associated with increased mortality risk, according to a study published online April 8 in Communications Medicine.
Sepideh Mehravar, M.D., from Cedars-Sinai in Los Angeles, and colleagues examined the association between long-term pharmacotherapies and all-cause mortality in a retrospective cohort study using a nationwide U.S. electronic health record database. A total of 699,083 adults (aged 18 to 65 years) with IBS were included in the cohort. Patients were categorized according to pharmacotherapy use; subgroup analyses included IBS with diarrhea (IBS-D) and IBS with constipation (IBS-C).
The researchers observed an association for antidepressant use with an increased risk for all-cause mortality (hazard ratio, 1.35; mortality rate, 1.6 versus 1.0 percent). Across antidepressant subclasses and demographic subgroups, this association remained consistent. There was no association seen for antispasmodic use with increased mortality. Cholestyramine/colestipol, eluxadoline, and rifaximin were not associated with mortality for IBS-D, but an increased mortality risk was seen for diphenoxylate and loperamide (hazard ratios, 1.89 and 2.39, respectively). No significant associations for mortality were seen for polyethylene glycol-3350 and secretagogues in IBS-C.
"IBS patients should not panic, but they do need to understand and weigh the small but meaningful risks when considering long-term treatments," senior author Ali Rezaie, M.D., also from Cedars-Sinai, said in a statement. "Patients should speak with their health care provider about the safest and most effective options for managing their symptoms."
Several authors disclosed ties to the biopharmaceutical industry.