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Meta-Analysis
. 2009 Apr 7;15(13):1548-53.
doi: 10.3748/wjg.15.1548.

Efficacy of tricyclic antidepressants in irritable bowel syndrome: a meta-analysis

Roja Rahimi  1 , Shekoufeh Nikfar, Ali Rezaie, Mohammad Abdollahi
Affiliations
Meta-Analysis

Efficacy of tricyclic antidepressants in irritable bowel syndrome: a meta-analysis

Roja Rahimi et al. World J Gastroenterol. .

Abstract

We aimed to evaluate the efficacy of tricyclic antidepressants (TCAs) as a therapeutic option for irritable bowel syndrome (IBS) through meta-analysis of randomized controlled trials. For the years 1966 until September 2008, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for double-blind, placebo-controlled trials investigating the efficacy of TCAs in the management of IBS. Seven randomized, placebo-controlled clinical trials met our criteria and were included in the meta-analysis. TCAs used in the treatment arm of these trials included amitriptyline, imipramine, desipramine, doxepin and trimipramine. The pooled relative risk for clinical improvement with TCA therapy was 1.93 (95% CI: 1.44 to 2.6, P < 0.0001). Effect size of TCAs versus placebo for mean change in abdominal pain score among the two studies was -44.15 (95% CI: -53.27 to -35.04, P < 0.0001). It is concluded that low dose TCAs exhibit clinically and statistically significant control of IBS symptoms.

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Figures

Figure 1
Figure 1
Flow diagram of the study selection process.
Figure 2
Figure 2
Outcome of “clinical response” in the studies considering TCAs vs placebo therapy. A: Individual and pooled relative risk; B: Heterogeneity indicators; C: Publication bias funnel plot.
Figure 3
Figure 3
Pooled weighted mean difference for the outcome of “mean change in abdominal pain score” in the studies considering TCAs vs placebo.
See this image and copyright information in PMC

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