Key Takeaways
- Antidepressants can slow down the digestive process, leading to constipation.
- To ease constipation, eat high-fiber foods like fruits and vegetables and drink plenty of water.
- If constipation continues, talk to your doctor about your symptoms and possible remedies.
Antidepressants can be an effective treatment for depression, but they can also have side effects. People who use medications like antidepressants may potentially become constipated. This side effect can be uncomfortable, but there are strategies you can try to find relief.
Learn more about why this side effect happens, what to watch for, and what you can do to relieve this side effect.
Why Antidepressants Can Cause Constipation
Constipation is a common side effect of tricyclic antidepressants such as Elavil (amitriptyline) and Norpramin (desipramine). In addition to treating depression, tricyclic antidepressants may also be prescribed to treat anxiety or insomnia.
Tricyclic antidepressants block the action of the neurotransmitter acetylcholine. When this neurotransmitter is blocked, the muscular contractions which propel waste matter through the digestive tract are slowed, and the intestinal secretions which lubricate the passage of feces are drier, causing constipation.
Because of their gastrointestinal effects, tricyclic antidepressants are sometimes prescribed to help slow activity in the digestive tract. For example, they might be prescribed to help treat conditions such as diarrhea and irritable bowel syndrome (IBS).
Other Possible Causes of Constipation
Many different factors can contribute to constipation. It can be a side effect of medications such as antidepressants, but it can also be caused by pregnancy, lifestyle choices, and certain medical conditions. Some causes that might lead to constipation include:
Lifestyle Factors
- Low fiber diet
- Dehydration
- Lack of exercise
- Changes in daily routine
- Consuming certain foods such as cheese or milk
- Stress
Medical Conditions
- Diabetes
- Diverticular disease
- Hypothyroidism
- Intestinal obstruction
- Irritable bowel syndrome
- Pregnancy
Medications
- Allergy medications
- Antacids
- Blood pressure medications
- Ibruprofen
- Iron supplements
- Pain medications
Constipation is a common side effect of many medications. Always read package inserts and talk to your doctor if you are concerned about symptoms or side effects that you are experiencing.
Constipation Symptoms
When a person has constipation, this means that their bowel movements have become more difficult and/or less frequent than what is normal. This can then lead to unpleasant symptoms such as:
- Dry, hard stools
- Feeling bloated
- Feeling like they didn’t completely empty their bowel
- Less frequent bowel movements
- Nausea
- Small or hard stools
- Straining during bowel movements
- Stomach ache and cramps
- Swollen or painful abdomen
- Vomiting
Although what is considered normal varies, most people will have a bowel movement between three times a day to once or twice a week. If the time between bowel movements begins to stretch longer, however, then it can become very uncomfortable when they finally do occur.
Relieving Constipation
If you are experiencing symptoms of constipation caused by an antidepressant, some self-care strategies can help you find relief:
- Consume prunes or bran cereal
- Drink plenty of water and avoid alcohol and caffeinated beverages, which can contribute to dehydration
- Eat high-fiber foods, such as fruits, vegetables, and whole grains
- Get regular exercise
- Limit your daily intake of fatty foods, including cheese, eggs, and meat
- Take fiber supplements
- Use stool softeners or laxatives if other steps to relieve constipation have failed
Do not take laxatives for longer than two weeks. The overuse of laxatives can make your symptoms worse.
When to Talk to Your Doctor
If you are experiencing symptoms of constipation and self-care has not provided sufficient relief, talk to your doctor about what you are experiencing. They can assess your condition and help recommend treatments and remedies that can help.
- While your symptoms may have begun after you started an antidepressant, your doctor may still want to rule out other possible causes. They will ask questions about your symptoms, take a medical history, and discuss your lifestyle habits, including information about diet and exercise.
- They may also order lab tests, imaging tests, or a colonoscopy to help rule out medical conditions contributing to your constipation symptoms.
- Your doctor might recommend specific lifestyle changes such as consuming more dietary fiber and drinking more water.
- They may also suggest over-the-counter remedies that can provide relief. If your constipation is severe or if other methods have not worked, they might opt to prescribe a medication to treat constipation.
If side effects are disruptive or distressing, your doctor may also consider changing the dosage of your medication or switching to a different type of antidepressant.
Potential Complications
Constipation can cause other problems, including:
- Hemorrhoids: Swollen, inflamed veins
- Anal fissures: Tears in the lining of the anus
- Diverticulitis: Infection in the colon wall
- Incontinence: Inability to control bladder muscles due to damage to the pelvic floor muscles
In extreme cases, people may experience what is known as fecal impaction, in which a hard mass of stool remains stuck in the rectum and cannot be passed.
Signs of Fecal Impaction
Fecal impaction can occur with long-term constipation and can potentially have some very serious complications, including tearing of the rectum or colon. If a person is experiencing fecal impaction after having long-term constipation, they may begin to have the following additional symptoms:
- Bladder pressure or loss of bladder control
- Fast heartbeat or dizziness when straining to pass stool
- Leakage of liquid stools or sudden watery diarrhea
- Lower back pain
- Rectal bleeding
- Significant cramping or bloating
If you have already become impacted, your doctor will take steps to remove the impacted stool. This may be done by using warm mineral oil enemas to soften and lubricate the stool, manually removing the impaction, or using laxatives. Very rarely, surgery may necessary to remove an impaction.
People who have had a fecal impaction will also need to undergo a bowel retraining program, possibly including stool softeners, fiber supplements, dietary changes, special exercises, and other techniques.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Santarsieri D, Schwartz TL. Antidepressant efficacy and side-effect burden: a quick guide for clinicians. Drugs Context. 2015;4:212290. doi:10.7573/dic.212290
Oliva V, Lippi M, Paci R, Del Fabro L, Delvecchio G, Brambilla P, De Ronchi D, Fanelli G, Serretti A. Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2021;109:110266. doi:10.1016/j.pnpbp.2021.110266
National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of constipation.
National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for constipation.
Obokhare I. Fecal impaction: a cause for concern? Clin Colon Rectal Surg. 2012;25(1):53-8. doi:10.1055/s-0032-1301760
Additional Reading
Patel, Sonal M., and Anthony J. Lembo. “Chapter 12 – Constipation.” Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. Eds. Mark Feldman et. al. 8th ed. Philadelphia: Sauders Elsevier, 2006.
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