People with Crohn’s disease or ulcerative colitis were less likely to experience flares if they started using antidepressant medication. That’s the key finding of a Danish study, published last month in the journal Inflammatory Bowel Diseases.

Researchers utilized info from a large database of nearly 43,000 patients with Crohn’s or ulcerative colitis, two forms of inflammatory bowel disease (IBD). They found that IBD patients who also used antidepressant medication generally had lower rates of disease activity. In turn, they were less likely to need “step-up” medication, such as corticosteroids and anti-tumor necrosis factor (TNF) drugs. They were less likely to be hospitalized for complications related to IBD.

It’s possible that controlling anxiety and depression keeps inflammation down, which makes IBD flares less likely. Some antidepressant medications seem to have direct anti-inflammatory effects, but whether the drugs themselves are responsible from preventing IBD from worsening is not clear.

People who are depressed are often less likely to take good care of themselves, so those who are depressed but not on antidepressants might be less apt to stick with their prescribed IBD treatment regimen. 

Interestingly, the connection between lower disease activity and antidepressants was especially strong for IBD patients who started taking antidepressants after they were diagnosed with IBD (as opposed to continuing on antidepressants they had started earlier). 

“To our knowledge, this study is the first to demonstrate that the beneficial influence of antidepressants on the risk of disease relapse is more pronounced in patients with no prior history of antidepressant treatment,” the study authors wrote. “Two possible hypotheses may explain this. First, patients treated with antidepressants before IBD onset may not benefit further from the potential anti-inflammatory effect of the [antidepressant]… Second, patients treated with antidepressants before IBD onset may be more vulnerable during the disease course due to mental challenges unrelated to IBD.”

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