Treatment of functional dyspepsia with antianxiety or antidepressive agents: systematic review.
BACKGROUND
The pathophysiology of functional dyspepsia (FD) has not been elucidated precisely; accordingly, effective management of FD has not yet been found. Until now, treatment with antianxiety or antidepressive agents has been empirically applied; however, the efficacy of these treatments has not been established. We carried out this study to estimate the efficacy of these treatment approaches by systematically reviewing the literature concerning trials with agents that are efficacious against anxiety, neurosis, or depression.


METHODS
Articles were searched from the MEDLINE database up to October 2003, using the terms, "antianxiety agents", "antidepressants", and "dyspepsia", and from reference lists of published articles. Finally, studies in which the effectiveness of drugs was clearly stated were selected from the retrieved articles.


RESULTS
Thirteen articles, on 1717 patients, were selected from among 90 articles retrieved through our literature search. In 11 of the 13 studies, dyspeptic symptoms were improved significantly by treatment. Statistical analysis of 4 trials showed a significant benefit of treatment with antianxiety or antidepressive agents (pooled relative risk, 0.55; 95% confidence interval [CI], 0.36-0.85), although funnel plots were asymmetric.


CONCLUSIONS
Antianxiety or antidepressive agents may be effective in the treatment of FD patients, though further clinical trials are necessary.
Hojo
Mariko
M
Department of Gastroenterology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Miwa
Hiroto
H
Yokoyama
Tetsuji
T
Ohkusa
Toshifumi
T
Nagahara
Akihito
A
Kawabe
Masato
M
Asaoka
Daisuke
D
Izumi
Yuko
Y
Sato
Nobuhiro
N
D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents; D004415:Dyspepsia / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents