Treatment of functional gastrointestinal disorders with antidepressant medications: A meta-analysis

被引:313
作者
Jackson, JL
O'Malley, PG
Tomkins, G
Balden, E
Santoro, J
Kroenke, K
机构
[1] Uniformed Serv Univ Hlth Sci, Dept Med EDP, Bethesda, MD 20814 USA
[2] Walter Reed Army Med Ctr, Dept Med, Washington, DC 20307 USA
[3] William Beaumont Army Med Ctr, Dept Med, El Paso, TX 79920 USA
[4] Univ Indianapolis, Sch Med, Regenstrief Inst Hlth Care, Dept Med, Indianapolis, IN 46227 USA
关键词
D O I
10.1016/S0002-9343(99)00299-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. Am 1 Med. 2000;108: 65-72. (C)2000 by Excerpta Medica, Inc.
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页码:65 / 72
页数:8
相关论文
共 70 条
[1]   THE EFFICACY OF AMINEPTINE IN THE TREATMENT OF DEPRESSIVE PATIENTS WITH IRRITABLE BOWEL SYNDROME [J].
ALEVIZOS, B ;
CHRISTODOULOU, GN ;
IOANNIDIS, C ;
VOULGARI, A ;
MANTIDIS, A ;
SPILIADIS, C .
CLINICAL NEUROPHARMACOLOGY, 1989, 12 :S66-S76
[2]   THE EFFECT OF COARSE WHEAT BRAN IN THE IRRITABLE BOWEL SYNDROME - A DOUBLE-BLIND CROSSOVER STUDY [J].
ARFFMANN, S ;
ANDERSEN, JR ;
HEGNHOJ, J ;
DEMUCKADELL, OBS ;
MOGENSEN, NB ;
KRAG, E .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1985, 20 (03) :295-298
[3]  
ARGEUS L, 1995, GASTROENTEROLOGY, V109, P671
[4]  
Balden E. L., 1999, JGIM, V14, P9
[5]   Treatment of irritable bowel syndrome with Chinese herbal medicine - A randomized controlled trial [J].
Bensoussan, A ;
Talley, NJ ;
Hing, M ;
Menzies, R ;
Guo, A ;
Ngu, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 280 (18) :1585-1589
[6]   EFFECTS OF ASCORBIC-ACID ON COMMON COLD - EVALUATION OF EVIDENCE [J].
CHALMERS, TC .
AMERICAN JOURNAL OF MEDICINE, 1975, 58 (04) :532-536
[7]   EFFECT OF DIETARY FIBER ON SYMPTOMS AND RECTOSIGMOID MOTILITY IN PATIENTS WITH IRRITABLE BOWEL SYNDROME - A CONTROLLED, CROSSOVER STUDY [J].
COOK, IJ ;
IRVINE, EJ ;
CAMPBELL, D ;
SHANNON, S ;
REDDY, SN ;
COLLINS, SM .
GASTROENTEROLOGY, 1990, 98 (01) :66-72
[8]   METAANALYSIS IN CLINICAL-TRIALS [J].
DERSIMONIAN, R ;
LAIRD, N .
CONTROLLED CLINICAL TRIALS, 1986, 7 (03) :177-188
[9]   UNITED-STATES HOUSEHOLDER SURVEY OF FUNCTIONAL GASTROINTESTINAL DISORDERS - PREVALENCE, SOCIODEMOGRAPHY, AND HEALTH IMPACT [J].
DROSSMAN, DA ;
LI, ZM ;
ANDRUZZI, E ;
TEMPLE, RD ;
TALLEY, NJ ;
THOMPSON, WG ;
WHITEHEAD, WE ;
JANSSENS, J ;
FUNCHJENSEN, P ;
CORAZZIARI, E ;
RICHTER, JE ;
KOCH, GG .
DIGESTIVE DISEASES AND SCIENCES, 1993, 38 (09) :1569-1580
[10]   SEXUAL AND PHYSICAL ABUSE IN WOMEN WITH FUNCTIONAL OR ORGANIC GASTROINTESTINAL DISORDERS [J].
DROSSMAN, DA ;
LESERMAN, J ;
NACHMAN, G ;
LI, ZM ;
GLUCK, H ;
TOOMEY, TC ;
MITCHELL, CM .
ANNALS OF INTERNAL MEDICINE, 1990, 113 (11) :828-833