In patients with microscopic colitis, what do you recommend on stopping SSRIs?
What alternatives do you recommend?
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Which of the following drug classes do you discontinue or switch for microscopic colitis patients?
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2 Answers
Mednet MemberInvited Expert
Gastroenterology · Icahn School of Medicine at Mount Sinai
Answered on
First, make sure the problem is not NSAIDs, PPIs, or statins.
Second, remember that the evidence linking SSRIs to microscopic colitis is not iron-clad.
Third, if you want to do a trial of a different class of antidepressant, the evidence linking SNRIs to microscopic colitis is even less consistent.
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Mednet MemberInvited Expert
Gastroenterology · NYU Langone Medical Center
Answered on
It depends on the indication of SSRI and severity of MC symptoms and treatment response. For anxiety or depression, many safe and effective alternatives are available.
For MC, budesonide is first-line and can be tapered to a minimum dose.
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