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Abstract

BackgroundA number of studies have suggested a link between the patient's psyche and the course of inflammatory bowel disease (IBD). Although pharmacotherapy with antidepressants has not been widely explored, some investigators have proposed that treating psychological co-morbidities with antidepressants may help to control disease activity. To date a systematic analysis of the available studies assessing the efficacy of antidepressants for the control of somatic symptoms in IBD patients has not been performed.MethodsWe searched electronic databases, without any language restriction. All relevant papers issued after 1990 were examined.Results12 relevant publications were identified. All of them referred to non-randomised studies. Antidepressants reported in these publications included paroxetine, bupropion, amitriptyline, phenelzine, and mirtazapine. In 10 articles, paroxetine, bupropion, and phenelzine were suggested to be effective for treating both psychological and somatic symptoms in patients suffering from IBD. Amitriptyline was found ineffective for treating somatic symptoms of IBD. Mirtazapine was not recommended for IBD patients.ConclusionAlthough 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. Properly designed trials are justified and needed based upon the available uncontrolled data.

Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management

“…82 Recent consensus guidelines for CD management include recommendations to assess for anxiety and depression and identify appropriate treatment if needed. 83 The concerns about psychiatric impact and need for intervention have been recognized in other chronic illness populations as well, with recent advisories recommending routine screening for depression for those with heart disease or diabetes.…”

“…82 Based on the available literature, including an open-label study and six case reports, it was found that the targeted anxiety or depression in IBD patients was generally responsive to pharmacological treatment. In addition, there was a positive effect on disease activity in the majority of the reports, which primarily involved use of the antidepressants paroxetine or buproprion.…”

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

“…The SSRI and SNRI medications are secondgeneration antidepressants that have been well established in the literature as being similarly effective for anxiety and depression [54] . In humans, it has been observed that although antidepressants improve both the mental and somatic status of IBD patients, the low quality of available research provides significant barriers to making a definitive statement on their efficacy or lack thereof [55] . Animal models, however, have found a positive impact of desipramine and fluoxetine on inflammation in models of IBD.…”

“…Amitriptyline is an antidepressant drug that is widely used for the treatment of IBD and gastrointestinal disorders [55,63] . It is effective for treating psychological and somatic symptoms in patients suffering from IBD [55] .…”

“…It is effective for treating psychological and somatic symptoms in patients suffering from IBD [55] . Other studies have shown the anti-inflammatory effects more often than their healthy peers [43] .…”