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

@article{Ford2014EffectOA,
  title={Effect of Antidepressants and Psychological Therapies, Including Hypnotherapy, in Irritable Bowel Syndrome: Systematic Review and Meta-Analysis},
  author={Alexander Charles Ford and Eamonn M M Quigley and Brian E. Lacy and Anthony J. Lembo and Yuri A Saito and Lawrence R. Schiller and Edy Soffer and Brennan M. R. Spiegel and Paul Moayyedi},
  journal={The American Journal of Gastroenterology},
  year={2014},
  volume={109},
  pages={1350-1365}
}
OBJECTIVES:Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. Evidence relating to the treatment of this condition with antidepressants and psychological therapies continues to accumulate.METHODS:We performed an updated systematic review and meta-analysis of randomized controlled trials (RCTs). MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched (up to December 2013). Trials recruiting adults with IBS, which compared antidepressants with… 

Effect of Antidepressants and Psychological Therapies in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-analysis

TLDR
Antidepressants are efficacious in reducing symptoms in IBS patients and psychological therapies also appear to be effective treatments for IBS, although there are limitations in the quality of the evidence, and treatment effects may be overestimated as a result.

Effect of Antidepressants and Psychological Therapies in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-Analysis

TLDR
Antidepressants are efficacious in reducing symptoms in IBS patients and psychological therapies also appear to be effective treatments for IBS, although there are limitations in the quality of the evidence, and treatment effects may be overestimated as a result.

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TLDR
The placebo response rate (PRR) was computed for IBS symptom severity as well as for anxiety, depression and quality of life (secondary outcome measures) and contrary to expectations, the PRR in studies on psychological interventions was comparable to that in Studies on pharmacological, dietary and alternative medical interventions.

Short-term and Long-term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis.

Efficacy and Safety of Antidepressants for the Treatment of Irritable Bowel Syndrome: A Meta-Analysis

TLDR
TCAs can improve global symptoms of irritable bowel syndrome, while there was no strong evidence to confirm the effectiveness of SSRIs for the treatment of IBS.

Antidepressants vs. Placebo for the Treatment of Functional Gastrointestinal Disorders in Adults: A Systematic Review and Meta-Analysis

TLDR
Antidepressants were inferior to placebo in terms of tolerability and partly superior regarding efficacy and before prescribing antidepressants, the benefits and side effects should be carefully evaluated.

Efficacy of probiotic adjuvant therapy for irritable bowel syndrome in children: A systematic review and meta-analysis

Objective Irritable bowel syndrome (IBS) affects children’s quality of life and learning. The purpose of this research was to systematically evaluate the efficacy of probiotic adjuvant therapy for
...

References

SHOWING 1-10 OF 92 REFERENCES

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

TLDR
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.

Antidepressant Therapy (Imipramine and Citalopram) for Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Trial

TLDR
Neither imipramine nor citalopram significantly improved global IBS endpoints over placebo, and approximately 20% of the variance in scores was explained by treatment differences for abdominal pain, bowel symptom severity disability, depression and the mental component of the SF-36.

The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome.

TLDR
For patients with severe IBS, both psychotherapy and paroxetine improve health-related quality of life at no additional cost.

Doxepin is more effective than nortriptyline and placebo for the treatment of diarrhea-predominant irritable bowel syndrome: a randomized triple-blind placebo-controlled trial

TLDR
Both doxepin and nortriptyline are effective for the treatment of diarrhea-predominant irritable bowel syndrome in a period of two months but doxEPin seems to be more efficacious than nortriptYline in this regard, but larger comparative trials are suggested.

Randomized Controlled Trial of Cognitive–Behavioral Group Therapy for Irritable Bowel Syndrome in a Medical Setting

TLDR
Reductions in GI symptoms, psychological distress, and improved health related quality of life may contribute to less behavioral avoidance, disability, and health care utilization in refractory IBS patients.

A double-blind, randomized, placebo-controlled trial of paroxetine controlled-release in irritable bowel syndrome.

TLDR
The study did not demonstrate a statistically significant benefit for paroxetine-CR over placebo on the primary outcome measure, although there was improvement in secondary outcome measures.

A randomized controlled trial of cognitive behavior therapy, relaxation training, and routine clinical care for the irritable bowel syndrome

TLDR
Cognitive behavior and relaxation therapy seem not to be superior to standard care alone in IBS, but all three arms showed similar improvement.

A randomized controlled trial of imipramine in patients with irritable bowel syndrome.

TLDR
Imipramine may be effective in the treatment of IBS patients and is associated with improved QoL, and careful patient selection, initiation of a low dose with gradual escalation and monitoring for side effects may result in an improved therapeutic response.

Comprehensive Self-Management for Irritable Bowel Syndrome: Randomized Trial of In-Person vs. Combined In-Person and Telephone Sessions

TLDR
A CSM program is efficacious whether delivered primarily by telephone or totally in person, and there is no evidence that replacing six of the in-person sessions by telephone sessions reduces the efficacy of the intervention.
...