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Therapeutics
Review: antidepressants are effective for clinical improvement in unexplained physical symptoms and syndromes

https://doi.org/10.1136/ebm.5.5.143

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    (1999) J Fam Pract. 48, 980. O'Malley PG, Jackson JL, Santoro J, et al.. Antidepressant therapy for unexplained symptoms and symptom syndromes.. Dec;. :. –90.
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 QUESTION: In adults who have medically unexplained physical symptoms (MUPS), do antidepressants improve outcomes?

    Data sources

    Studies were identified by searching Medline (1966–98), PsycLIT (1974–98), EMBASE/Excerpta Medica (1974–98), the Cochrane Library, the Federal Research in Progress database, and bibliographies of relevant articles.

    Study selection

    2 reviewers independently selected studies that were randomised controlled trials (RCTs) (including crossover trials), involved adults with MUPS, compared antidepressants with placebo or a non-antidepressant intervention, reported measurable outcomes, and were published in English.

    Data extraction

    Data extracted included symptoms, setting, treatment (regimens and follow up), patient characteristics, assessment of comorbid psychiatric disease, adverse effects, outcomes, statistical analysis of reported results, and quality of study methods (Jadad scale).

    Main results

    94 RCTs on 6 symptom syndromes met the selection criteria. 6595 patients …

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    Footnotes

    • Source of funding: In part, the MacArthur Foundation Initiative on Depression in Primary Care.

    • For correspondence: Dr P G O'Malley, Department of Medicine, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20307-5001, USA. Fax +1 202 782 7363.

    • Abstract and commentary also appear in Evidence-Based Mental Health.