Several studies have suggested that
antidepressants might be beneficial in the treatment of patients with
functional gastrointestinal disorders. This commentary discusses the results of a high-quality, multicenter, randomized, double-blind, placebo-controlled trial that showed no benefit of the
antidepressant venlafaxine over placebo in the treatment of a large group of patients with functional
dyspepsia. Moreover,
venlafaxine was poorly tolerated by a considerable number of patients. The routine use of
venlafaxine and other
serotonin and
norepinephrine reuptake-inhibitor
antidepressants to treat patients with functional
dyspepsia is, therefore, not recommended. Whether certain subgroups of patients, particularly those with anxious or depressive psychiatric comorbidities, might benefit from treatment with this class of
antidepressants, however, remains to be elucidated.
Antidepressants with different mechanisms of actions, for example
mirtazapine, might still prove beneficial for the treatment of functional
dyspepsia, but no clinical studies have yet investigated the efficacy of these drugs in this setting.