title: Treatment of functional chest pain with antidepressants: a meta-analysis.
abstract: BACKGROUND
  Recurrent Functional Chest pain (FCP) with normal coronary anatomy and no detectable gastroenterological and respiratory causes is a common problem that sometimes leads to excess use of medical care.
  
  
  OBJECTIVE
  The purpose of this meta-analysis is to investigate the efficacy of antidepressant treatments for FCP.
  
  
  METHODS
  MEDLINE, PsycINFO, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to July 2011. Randomized controlled trials (RCTs) that tested any type of antidepressants for FCP with normal coronary anatomy were analyzed. Diagnoses included non-specific chest pain, noncardiac chest pain, atypical chest pain, syndrome X, or chest pain with normal coronary anatomy.
  
  
  METHODS
  Two authors independently extracted data. Effects were summarized using standardized mean differences (SMDs), weighed mean differences (WMD), or odds ratio (OR) by suitable effects model.
  
  
  RESULTS
  Seven RCTs (median duration, 5 weeks; range, 3 - 16 weeks) involving 319 participants were included. There was strong evidence for an association of antidepressants with reduction in pain (SMD -1.26; 95% confidence interval [CI], -2.34 to -0.19) and psychological symptoms (SMD -0.87; 95% CI, -1.67 to - 0.08) as well as increased side effects (OR 0.34; 95% CI, 0.15 to 0.78). Current analysis did not support the association of antidepressants with improved health related quality of life (WMD 2.00; 95% CI, - 2.54 to - 6.65).
  
  
  CONCLUSIONS
  Demographics, co-morbidities of study participants and the amount of co-medication were not reported, these possible sources of heterogeneity could not be examined.
  
  
  CONCLUSIONS
  Antidepressant medications are associated with improvements in pain and psychological symptoms. The effects of factors including psychiatric co-morbidity, gender, age, ethnic group, and treating period on the outcomes should be checked further.
authors.affiliation: Department of Anatomy, Histology and Embryology, K.K. Leung Brain Research Centre, the Fourth Military Medical University, No. 169 West Chengle Road, Xi'an, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Wang
authors.forename: Yong-Hai
authors.initials: YH
authors.lastname: Sun
authors.forename: Ya-Yu
authors.initials: YY
authors.lastname: Wang
authors.forename: Yu-Tong
authors.initials: YT
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Yun-Qing
authors.initials: YQ
authors.lastname: Li
authors.forename: Sheng-Xi
authors.initials: SX
authors.lastname: Wu
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002637:Chest Pain / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents