Is elobixibat effective for treating chronic constipation in patients with depression?

Elobixibat is a newer type of laxative that works by increasing bile acids in the colon to stimulate bowel movements. For people with depression who also have chronic constipation, a large postmarketing surveillance study in Japan provides direct evidence that elobixibat is effective and generally well-tolerated. In that study, patients with depression who took elobixibat had improved bowel movement frequency and stool consistency, and side effects were uncommon.

What the research says

A prospective, multicenter postmarketing surveillance study in Japan specifically evaluated elobixibat for chronic constipation in patients with depression and schizophrenia ⁴. In the depression group, 129 patients were treated for 4 weeks and 55 for up to 52 weeks. The study found that elobixibat improved defecation frequency and Bristol Stool Form Scale scores, and adverse drug reactions occurred in only about 3.9% of patients in the 4-week group ⁴. This suggests elobixibat is both effective and safe in this population, even though many patients were also taking antipsychotics or other medications ⁴.

Other studies confirm elobixibat's general effectiveness for chronic constipation. A review article summarizing clinical trials found that elobixibat increases stool frequency and improves stool consistency in patients with chronic constipation, including those with severe or slow-transit constipation ⁷. A study in hemodialysis patients also showed significant improvements in bowel movements and quality of life after 4 weeks of elobixibat ⁸. Additionally, a study in patients with or without a gallbladder found that elobixibat significantly increased bowel movement frequency and improved stool form ⁶.

While the evidence for elobixibat in depression is promising, it comes from a single study. The gut-brain axis is thought to play a role in both constipation and depression, and other approaches like fecal microbiota transplantation or biofeedback have been studied for constipation in other conditions ¹². However, those treatments have not been specifically tested in patients with depression. The postmarketing study provides the most direct evidence for elobixibat in this group ⁴.

What to ask your doctor

• Is elobixibat a good option for my chronic constipation, given that I also have depression?
• How does elobixibat compare to other laxatives I might have tried?
• What side effects should I watch for with elobixibat, especially if I take other medications for depression?
• How long does it typically take for elobixibat to improve bowel movements?
• Should I continue my current constipation treatments while starting elobixibat?