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Review: antidepressants and psychological therapies improve symptoms of irritable bowel syndromeCommentary

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QUESTION

In patients with irritable bowel syndrome (IBS), do antidepressant medications or psychological therapies improve symptoms?

REVIEW SCOPE

Included studies compared antidepressants with placebo or psychological therapies with no treatment or usual care in adults (⩾16 y of age) with IBS diagnosed by established criteria or by a clinician’s opinion. Outcomes were persistent IBS symptoms and adverse events.

REVIEW METHODS

Medline and EMBASE/Excerpta Medica (to May 2008); Cochrane Central Register of Controlled Trials (2007); conference abstracts (2001-07); and references were searched for randomised controlled trials (RCTs) that involved ⩾7 days of treatment and ⩾7 days of follow-up. 13 RCTs of antidepressant therapy (n = 789, 44–100% women, 4–13 wks of treatment) and 20 RCTs of psychological therapy (n = 1278, 57–100% women, 6–26 wks of treatment) met the selection criteria. Methodological quality was generally good for the antidepressant trials (10 of 13 RCTs scored ⩾4 …

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