Mikocka-Walus Antonina A, Turnbull Deborah A, Moulding Nicole T, Wilson Ian G, Andrews Jane M, Holtmann Gerald J
School of Psychology and Discipline of General Practice, University of Adelaide, and Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, South Australia, Australia.
Clin Pract Epidemiol Ment Health. 2006 Sep 20;2:24. doi: 10.1186/1745-0179-2-24.
A number of studies have suggested a link between the patient's psyche and the course of inflammatory bowel disease (IBD). Although pharmacotherapy with antidepressants has not been widely explored, some investigators have proposed that treating psychological co-morbidities with antidepressants may help to control disease activity. To date a systematic analysis of the available studies assessing the efficacy of antidepressants for the control of somatic symptoms in IBD patients has not been performed.
We searched electronic databases, without any language restriction. All relevant papers issued after 1990 were examined.
12 relevant publications were identified. All of them referred to non-randomised studies. Antidepressants reported in these publications included paroxetine, bupropion, amitriptyline, phenelzine, and mirtazapine. In 10 articles, paroxetine, bupropion, and phenelzine were suggested to be effective for treating both psychological and somatic symptoms in patients suffering from IBD. Amitriptyline was found ineffective for treating somatic symptoms of IBD. Mirtazapine was not recommended for IBD patients.
Although most of reviewed papers suggest a beneficial effect of treatment with antidepressants in patients with IBD, due to the lack of reliable data, it is impossible to judge the efficacy of antidepressants in IBD. Properly designed trials are justified and needed based upon the available uncontrolled data.
多项研究表明患者的心理状态与炎症性肠病（IBD）的病程之间存在联系。尽管抗抑郁药的药物治疗尚未得到广泛探索，但一些研究人员提出，用抗抑郁药治疗心理合并症可能有助于控制疾病活动。迄今为止，尚未对评估抗抑郁药对IBD患者躯体症状控制疗效的现有研究进行系统分析。
我们检索了电子数据库，没有任何语言限制。对1990年后发表的所有相关论文进行了审查。
共识别出12篇相关出版物。所有这些都涉及非随机研究。这些出版物中报道的抗抑郁药包括帕罗西汀、安非他酮、阿米替林、苯乙肼和米氮平。在10篇文章中，帕罗西汀、安非他酮和苯乙肼被认为对治疗IBD患者的心理和躯体症状均有效。发现阿米替林对治疗IBD的躯体症状无效。不建议IBD患者使用米氮平。
尽管大多数综述论文表明抗抑郁药治疗对IBD患者有有益效果，但由于缺乏可靠数据，无法判断抗抑郁药在IBD中的疗效。基于现有的非对照数据，进行适当设计的试验是合理且必要的。
