Review

Antidepressants and inflammatory bowel disease: a systematic review

Antonina A Mikocka-Walus¹, Deborah A Turnbull², Nicole T Moulding³, Ian G Wilson⁴, Jane M Andrews⁵ and Gerald J Holtmann⁶

¹  School of Psychology and Discipline of General Practice, University of Adelaide, and Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, level 3, Eleanor Harrald Building, 5005 Adelaide, South Australia, Australia

²  School of Psychology, the University of Adelaide, level 4, Hughes Building, Adelaide 5005, South Australia, Australia

³  Nicole T. Moulding, Discipline of General Practice, the University of Adelaide, Level 3, Eleanor Harrald Building, Adelaide 5005, South Australia, Australia

⁴  School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith SouthDC 1797, New South Wales, Australia

⁵  Department of Gastroenterology, Hepatology and General Medicine, the Royal Adelaide Hospital, North Wing Q7, Adelaide 5005, South Australia, Australia

⁶  Department of Gastroenterology, Hepatology and General Medicine, the Royal Adelaide Hospital, North Wing Q7, Adelaide 5005, South Australia, Australia

Clinical Practice and Epidemiology in Mental Health 2006, 2:24doi:10.1186/1745-0179-2-24

Published:	20 September 2006

Abstract

Background

A 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.

Methods

We searched electronic databases, without any language restriction. All relevant papers issued after 1990 were examined.

Results

12 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.

Conclusion

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. Properly designed trials are justified and needed based upon the available uncontrolled data.