Antidepressants and inflammatory bowel disease: a systematic review.
BACKGROUND
A number of studies have suggested a link between the patient's psyche and the course of inflammatory bowel disease (IBD). Although pharmacotherapy with antidepressants has not been widely explored, some investigators have proposed that treating psychological co-morbidities with antidepressants may help to control disease activity. To date a systematic analysis of the available studies assessing the efficacy of antidepressants for the control of somatic symptoms in IBD patients has not been performed.


METHODS
We searched electronic databases, without any language restriction. All relevant papers issued after 1990 were examined.


RESULTS
12 relevant publications were identified. All of them referred to non-randomised studies. Antidepressants reported in these publications included paroxetine, bupropion, amitriptyline, phenelzine, and mirtazapine. In 10 articles, paroxetine, bupropion, and phenelzine were suggested to be effective for treating both psychological and somatic symptoms in patients suffering from IBD. Amitriptyline was found ineffective for treating somatic symptoms of IBD. Mirtazapine was not recommended for IBD patients.


CONCLUSIONS
Although most of reviewed papers suggest a beneficial effect of treatment with antidepressants in patients with IBD, due to the lack of reliable data, it is impossible to judge the efficacy of antidepressants in IBD. Properly designed trials are justified and needed based upon the available uncontrolled data.
Mikocka-Walus
Antonina A
AA
School of Psychology and Discipline of General Practice, University of Adelaide, and Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, South Australia, Australia. antonina.mikockawalus@adelaide.edu.au
Turnbull
Deborah A
DA
Moulding
Nicole T
NT
Wilson
Ian G
IG
Andrews
Jane M
JM
Holtmann
Gerald J
GJ