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News

Efficacy of psychotropic drugs in functional dyspepsia

March's issue of Gut examines the efficacy of psychotropic drugs in functional dyspepsia.

News image

Functional dyspepsia is a chronic gastroduodenal disorder. 

Individuals with functional dyspepsia demonstrate visceral hypersensitivity, abnormal central pain processing, and low mood, but it is unclear whether psychotropic drugs are an effective treatment for the condition. 

Professor Alexander Ford and colleagues from the United Kingdom performed a systematic review and meta-analysis of randomized controlled trials.

MEDLINE, EMBASE, EMBASE Classic, PsychINFO and the Cochrane Controlled Trials Register were searched for randomized controlled trials recruiting adults with functional dyspepsia comparing psychotropic drugs with placebo. 

The research team contacted authors directly to maximise trial eligibility and minimize risk of bias for studies. 

The team identified 2795 citations, of which 13 randomized controlled trials were eligible. 

The researchers found that 10 trials were at low risk of bias. 

The relative risk of functional dyspepsia symptoms not improving with psychotropic drugs versus placebo was 0.78. 

However, benefit was limited to antipsychotics and tricyclic antidepressants. 

When only studies that excluded individuals with coexistent mood disorder were considered, there was no benefit. 

The research team observed that total numbers of adverse events and adverse events leading to withdrawal were significantly more common, with a number needed to harm of 21 for both.

Professor Ford's team concludes, "Psychotropic drugs may be an effective treatment for functional dyspepsia, but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents, meaning that firm conclusions for efficacy cannot be made."

"More data from high quality randomized controlled trials are required to support their use in the treatment of functional dyspepsia."

Gut 2017;66:411-420
07 March 2017

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