Treatment of functional gastrointestinal disorders with antidepressant medications

A meta-analysis

Jeffrey L. Jackson, Patrick G. O'Malley, Glen Tomkins, Erin Balden, James Santoro, Kurt Kroenke

Research output: Contribution to journalArticle

430 Citations (Scopus)

Abstract

BACKGROUND: Functional gastrointestinal disorders are common, accounting for up to 50% of gastroenterology referrals, and several randomized controlled trials have evaluated antidepressant therapy for their treatment. METHODS: We performed a meta-analysis of published, English-language, randomized clinical trials on the use of antidepressants for the treatment of patients with functional gastrointestinal disorders. RESULTS: Twelve randomized placebo-controlled trials of antidepressant treatment of functional gastrointestinal disorders were identified. One was excluded for using a combination of a tricyclic and neuroleptic agent. The medications included tricyclic antidepressants (amitriptyline [n = 3], clomipramine [n = 1], desipramine [n = 2], doxepin [n = 1], and trimipramine [n = 2]), and the antiserotonin agent, mianserin (n = 2). In addition, one trial compared two different antidepressants (mianserin and clomipramine) with placebo. Data were abstracted for the dichotomous outcome of symptom improvement in seven studies, and for the continuous variable of pain score in eight studies. The summary odds ratio for improvement with antidepressant therapy was 4.2 (95% confidence interval [CI]: 2.3 to 7.9), and the average standardized mean improvement in pain was equal to 0.9 SD units (95% CI: 0.6 to 1.2 SD units). On average 3.2 patients needed to be treated (95% CI: 2.1 to 6.5 patients) to improve 1 patient's symptom. CONCLUSION: Treatment of functional gastrointestinal disorders with antidepressants appears to be effective. Whether this improvement is independent of an effect of treatment on depression needs further evaluation. Copyright (C) 2000 Excerpta Medica Inc.

Original languageEnglish
Pages (from-to)65-72
Number of pages8
JournalThe American Journal of Medicine
Volume108
Issue number1
DOIs
StatePublished - Jan 2000

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Gastrointestinal Diseases
Antidepressive Agents
Meta-Analysis
Mianserin
Clomipramine
Randomized Controlled Trials
Confidence Intervals
Therapeutics
Trimipramine
Placebos
Doxepin
Pain
Desipramine
Amitriptyline
Tricyclic Antidepressive Agents
Gastroenterology
Antipsychotic Agents
Language
Referral and Consultation
Odds Ratio

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Treatment of functional gastrointestinal disorders with antidepressant medications : A meta-analysis. / Jackson, Jeffrey L.; O'Malley, Patrick G.; Tomkins, Glen; Balden, Erin; Santoro, James; Kroenke, Kurt.

In: The American Journal of Medicine, Vol. 108, No. 1, 01.2000, p. 65-72.

Research output: Contribution to journalArticle

Jackson, Jeffrey L. ; O'Malley, Patrick G. ; Tomkins, Glen ; Balden, Erin ; Santoro, James ; Kroenke, Kurt. / Treatment of functional gastrointestinal disorders with antidepressant medications : A meta-analysis. In: The American Journal of Medicine. 2000 ; Vol. 108, No. 1. pp. 65-72.
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