Cited by 405Gastrointestinal motility and disordersInfant Health and DevelopmentPsychosomatic Disorders and Their Treatments

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

Ford, Alexander C, Quigley, Eamonn M M, Lacy, Brian E, Lembo, Anthony J, Saito, Yuri A, Schiller, Lawrence R, Soffer, Edy E, Spiegel, Brennan M R, Moayyedi, Paul·2014·American Journal of Gastroenterology

DOI 10.1038/ajg.2014.148

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Abstract

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 placebo, or psychological therapies with control therapy or "usual management," were eligible. Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). RESULTS: The search strategy identified 3,788 citations. Forty-eight RCTs were eligible for inclusion: thirty-one compared psychological therapies with control therapy or "usual management," sixteen compared antidepressants with placebo, and one compared both psychological therapy and antidepressants with placebo. Ten of the trials of psychological therapies, and four of the RCTs of antidepressants, had been published since our previous meta-analysis. The RR of IBS symptom not improving with antidepressants vs. placebo was 0.67 (95% CI=0.58-0.77), with similar treatment effects for both tricyclic antidepressants and selective serotonin reuptake inhibitors. The RR of symptoms not improving with psychological therapies was 0.68 (95% CI=0.61-0.76). Cognitive behavioral therapy, hypnotherapy, multicomponent psychological therapy, and dynamic psychotherapy were all beneficial. CONCLUSIONS: Antidepressants and some psychological therapies are effective treatments for IBS. Despite the considerable number of studies published in the intervening 5 years since we last examined this issue, the overall summary estimates of treatment effect have remained remarkably stable.

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Authors: Ford, A. C., Quigley, E. M. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., Soffer, E. E., Spiegel, B. M. R., & Moayyedi, P.
Affiliations: University of Leeds (GB)
Houston Methodist (US)
Dartmouth–Hitchcock Medical Center (US)
Beth Israel Deaconess Medical Center (US)
Mayo Clinic (US)
Baylor University Medical Center (US)
University of Southern California (US)
VA Greater Los Angeles Healthcare System (US)
McMaster University (CA)
Corresponding author: Ford, Alexander C
ORCID: Ford, Alexander C
Quigley, Eamonn M M
Lacy, Brian E
Lembo, Anthony J
Saito, Yuri A
Schiller, Lawrence R
Soffer, Edy E
Spiegel, Brennan M R
Moayyedi, Paul
Venue: American Journal of Gastroenterology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-09
Volume: 109
Issue: 9
Pages: 1350-1365
ISSN: 0002-9270 (ISSN-L)
DOI: 10.1038/ajg.2014.148
OpenAlex: W2171220209
Cited by: 405
References: 72
Citations by year: 2026: 10 · 2025: 15 · 2024: 15 · 2023: 13 · 2022: 27 · 2021: 29 · 2020: 28 · 2019: 51 · 2018: 60 · 2017: 61 · 2016: 46 · 2015: 41 · 2014: 6
FWCI: 8.39
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (unspecified)
Locations: The American Journal of Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Funders: American College of Gastroenterology
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: irritable bowel syndrome, antidepressants, psychotherapy, hypnotherapy, cognitive behavioral therapy, tricyclic antidepressants, selective serotonin reuptake inhibitors, psychodynamic psychotherapy, symptom remission, functional gastrointestinal disorders
MeSH terms: Antidepressive Agents, Antidepressive Agents, Tricyclic, Humans, Hypnosis, Psychotherapy, Relaxation Therapy, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Selective Serotonin Reuptake Inhibitors, Irritable Bowel Syndrome

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

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