title: Efficacy of psychotropic drugs in functional dyspepsia: systematic review and meta-analysis.
abstract: Functional dyspepsia (FD) is a chronic gastroduodenal disorder. Individuals with FD demonstrate visceral hypersensitivity, abnormal central pain processing, and low mood, but it is unclear whether psychotropic drugs are an effective treatment for the condition. We performed a systematic review and meta-analysis of randomised controlled trials (RCTs).
  
  
  
  MEDLINE, EMBASE, EMBASE Classic, PsychINFO and the Cochrane Controlled Trials Register were searched (up to June 2015) for RCTs recruiting adults with FD comparing psychotropic drugs with placebo. We contacted authors directly to maximise trial eligibility and minimise risk of bias for studies. Dichotomous symptom data were pooled to obtain relative risk (RR) of remaining symptomatic after therapy, with 95% CIs.
  
  
  
  The search identified 2795 citations; 13 RCTs (1241 patients) were eligible. Ten trials were at low risk of bias. The RR of FD symptoms not improving with psychotropic drugs versus placebo was 0.78 (95% CI 0.68 to 0.91) (number needed to treat=6; 95% CI 4 to 16). However, benefit was limited to antipsychotics and tricyclic antidepressants. When only studies that excluded individuals with coexistent mood disorder were considered, there was no benefit. Total numbers of adverse events and adverse events leading to withdrawal were significantly more common, with a number needed to harm of 21 for both.
  
  
  
  Psychotropic drugs may be an effective treatment for FD, but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents, meaning that firm conclusions for efficacy cannot be made. More data from high quality RCTs are required to support their use in the treatment of FD.
authors.affiliation: Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.|Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Ford
authors.affiliation: Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.
authors.forename: Pavit
authors.initials: P
authors.lastname: Luthra
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, Catholic University Leuven, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, Catholic University Leuven, Leuven, Belgium.
authors.forename: Guy E
authors.initials: GE
authors.lastname: Boeckxstaens
authors.affiliation: Gastroenterology Division, McMaster University, Health Sciences Center, Hamilton, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Moayyedi
authors.affiliation: Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
mesh_terms: D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D004415:Dyspepsia / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D019964:Mood Disorders / Q000150:complications / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs
keywords: FUNCTIONAL DYSPEPSIA