Rahimi R, Nikfar S, Rezaie A, Abdollahi M. Efficacy of tricyclic antidepressants in irritable bowel syndrome: A meta-analysis. World J Gastroenterol 2009; 15(13): 1548-1553 [PMID: 19340896 DOI: 10.3748/wjg.15.1548]
Corresponding Author of This Article
Mohammad Abdollahi, Professor, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran 1417614411, Iran. mohammad@tums.ac.ir
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Editorial
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World J Gastroenterol. Apr 7, 2009; 15(13): 1548-1553 Published online Apr 7, 2009. doi: 10.3748/wjg.15.1548
Efficacy of tricyclic antidepressants in irritable bowel syndrome: A meta-analysis
Roja Rahimi, Shekoufeh Nikfar, Ali Rezaie, Mohammad Abdollahi
Roja Rahimi, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Shekoufeh Nikfar, Food & Drug Affairs, and Food & Drug Laboratory Research Center, Ministry of Health & Medical Education, Tehran 1314715311, Iran
Ali Rezaie, Faculty of Medicine, University of Alberta, Edmonton T6G 2V2, Canada
Mohammad Abdollahi, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Author contributions: Rahimi R collected data and drafted the manuscript; Nikfar S conducted meta-analysis, reviewed data and the manuscript; Rezaie A completed searches and reviewed the manuscript; Abdollahi M supervised whole study and edited the manuscript.
Correspondence to: Mohammad Abdollahi, Professor, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran 1417614411, Iran. mohammad@tums.ac.ir
Telephone: +98-21-66959104
Fax: + 98-21-66959104
Received: December 3, 2008 Revised: February 23, 2009 Accepted: March 2, 2009 Published online: April 7, 2009
Abstract
We aimed to evaluate the efficacy of tricyclic antidepressants (TCAs) as a therapeutic option for irritable bowel syndrome (IBS) through meta-analysis of randomized controlled trials. For the years 1966 until September 2008, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for double-blind, placebo-controlled trials investigating the efficacy of TCAs in the management of IBS. Seven randomized, placebo-controlled clinical trials met our criteria and were included in the meta-analysis. TCAs used in the treatment arm of these trials included amitriptyline, imipramine, desipramine, doxepin and trimipramine. The pooled relative risk for clinical improvement with TCA therapy was 1.93 (95% CI: 1.44 to 2.6, P < 0.0001). Effect size of TCAs versus placebo for mean change in abdominal pain score among the two studies was -44.15 (95% CI: -53.27 to -35.04, P < 0.0001). It is concluded that low dose TCAs exhibit clinically and statistically significant control of IBS symptoms.
