Antidepressant therapy (imipramine and citalopram) for irritable bowel syndrome: a double-blind, randomized, placebo-controlled trial.

Abstract

BACKGROUND:

The efficacy of antidepressants in irritable bowel syndrome (IBS) is controversial. No trials have directly compared a tricyclic with a selective serotonin reuptake inhibitor. Our aim was to determine whether imipramine and citalopram are efficacious in IBS.

METHODS:

This was a randomized, double-blind, placebo-controlled, parallel group pilot trial with imipramine (50 mg) and citalopram (40 mg).

RESULTS:

Of 51 IBS patients randomized, baseline characteristics were comparable among the treatment arms; the majority was diarrhea-predominant. Adequate relief of IBS symptoms (primary endpoint) was similar for each treatment arm. Improvements in bowel symptom severity rating for interference (P = 0.05) and distress (P = 0.02) were greater with imipramine versus placebo, but improvements in abdominal pain were not. There was a greater improvement in depression score (P = 0.08) and in the SF-36 Mental Component Score (P = 0.07), with imipramine. Citalopram was not superior to placebo. Approximately 20% of the variance in scores was explained by treatment differences for abdominal pain, bowel symptom severity disability, depression and the mental component of the SF-36.

CONCLUSION:

Neither imipramine nor citalopram significantly improved global IBS endpoints over placebo.

• Authors: Nicholas J Talley, John E Kellow, Philip Boyce, Christopher Tennant, Sandy Huskic, Michael Jones
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 53 Issue 1 Pg. 108-15 (Jan 2008) ISSN: 0163-2116 [Print] United States
• PMID: 17503182 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents, Second-Generation
• Antidepressive Agents, Tricyclic
• Citalopram
• Imipramine

Topics

• Adult
• Antidepressive Agents, Second-Generation (therapeutic use)
• Antidepressive Agents, Tricyclic (therapeutic use)
• Citalopram (therapeutic use)
• Double-Blind Method
• Female
• Follow-Up Studies
• Humans
• Imipramine (therapeutic use)
• Irritable Bowel Syndrome (drug therapy)
• Male
• Patient Satisfaction
• Pilot Projects
• Prospective Studies
• Treatment Outcome