Antidepressants in Inflammatory Bowel Disease: A Systematic Review

@article{Macer2017AntidepressantsII,
  title={Antidepressants in Inflammatory Bowel Disease: A Systematic Review},
  author={Benjamin Macer and Stephanie L. Prady and Antonina Mikocka-Walus},
  journal={Inflammatory Bowel Diseases},
  year={2017},
  volume={23},
  pages={534–550}
}
Background: Antidepressants are commonly used to treat symptoms of anxiety and depression in inflammatory bowel disease (IBD. [] Key Method Results: Fifteen eligible studies included in the review (1 randomized controlled trial, 2 cohorts, 1 case–control, 1 cross-sectional survey, 1 qualitative, 2 audits, 1 case series, and 6 case reports) examined a range of antidepressants. Twelve studies suggested that antidepressants have a positive impact on IBD course. Nine studies reported anxiety and depression as…

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References

SHOWING 1-10 OF 42 REFERENCES

Adjuvant therapy with antidepressants for the management of inflammatory bowel disease.

The efficacy and safety of antidepressants for treating anxiety and depression in IBD, and the effects of antidepressants on quality of life (QoL) and managing disease activity in I BD are assessed.

Can antidepressants influence the course of inflammatory bowel disease? The current state of research

Overall, the studies suggest a positive impact of antidepressants on inflammation in IBD, however, good-quality human data are lacking and more RCTs are needed.

Antidepressants and inflammatory bowel disease: a systematic review

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.

Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases

The high rates of anxiety and depression for those with IBD, particularly when disease is active, warrant a systemic approach to screening and treatment.

Do Antidepressants Influence the Disease Course in Inflammatory Bowel Disease? A Retrospective Case‐Matched Observational Study

Antidepressants, when used to treat concomitant mood disorders in IBD, seem to reduce relapse rates, use of steroids, and endoscopies in the year after their introduction, suggesting the need for a prospective controlled trial to evaluate their effects on disease course in patients with IBD.

Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis

Antidepressants are effective in the treatment of IBS and there is less high-quality evidence for routine use of psychological therapies in IBS, but available data suggest these may be of comparable efficacy.

Effect of Antidepressants and Psychological Therapies, Including Hypnotherapy, in Irritable Bowel Syndrome: Systematic Review and Meta-Analysis

Antidepressants and some psychological therapies are effective treatments for IBS, and summary estimates of treatment effect have remained remarkably stable since the previous meta-analysis.

A magic pill? A qualitative analysis of patients’ views on the role of antidepressant therapy in inflammatory bowel disease (IBD)

Antidepressants seem to be well tolerated by IBD patients and the positive attitude towards antidepressants in these participants may make the conduct of clinical trials to further assess for any specific role on IBD course feasible.

Tricyclic Antidepressants for Management of Residual Symptoms in Inflammatory Bowel Disease

In a clinical practice setting, TCA use led to moderate improvement of residual gastrointestinal symptoms in IBD patients for whom escalation of IBD therapy was not planned.