Study: 2 Common IBS Drug Classes Linked to Higher Death Risk
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- Cedars-Sinai researchers published the largest-ever real-world study on IBS medication safety, analyzing nearly 20 years of electronic health records from more than 650,000 U.S. adults diagnosed with the condition.
- Antidepressants were associated with a 35% increase in death risk among long-term IBS patients, even though they are not FDA-approved specifically for IBS and are prescribed off-label for pain and symptom management.
- Loperamide and diphenoxylate, commonly recommended opioid-based antidiarrheal drugs, were linked to roughly double the risk of death compared to non-users in the study.
- FDA-approved IBS medications and antispasmodics showed no association with increased mortality, suggesting the elevated risk is concentrated in specific drug classes rather than across all IBS treatments.
- Ali Rezaie, MD, the study's senior author and Cedars-Sinai's GI Motility Program director, stressed that the findings show correlation—not causation—and that associations may reflect underlying cardiovascular events, falls, and stroke rather than the drugs themselves.
- IBS affects roughly 10% of U.S. adults, and most patients are diagnosed young enough to remain on medications for years—far longer than the less-than-one-year duration of typical clinical trials.
Why it matters: With roughly 10% of Americans living with IBS and many on medication for years, the finding that antidepressants carry a 35% higher death risk and opioid-based antidiarrheals roughly double it could reshape long-term prescribing guidelines—though researchers stress the absolute individual risk remains low and FDA-approved IBS drugs and antispasmodics showed no elevated risk.
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