Selective serotonin reuptake inhibitors are frequently used in the treatment of irritable bowel syndrome (IBS).
Evidence of their efficacy is scarce.
Dr Tack and colleagues from Belgium recruited 23 non-depressed irritable bowel syndrome patients from a tertiary care center.
The research team conducted a crossover trial comparing 6 weeks of treatment with the selective serotonin reuptake inhibitors citalopram with placebo.
The patients were given citalopram 20 mg for 3 weeks then 40 mg for 3 weeks.
Irritable bowel syndrome symptom severity was the primary outcome measure.
|The therapeutic effect was independent of effects on colonic sensorimotor function|
The researchers also measured depression and anxiety scores.
The effect of acute administration of citalopram on colonic sensitivity and on colonic response to feeding was assessed as a predictor of response to the drug.
The research team found after 3 and 6 weeks of treatment that citalopram improved abdominal pain, and bloating.
Impact of symptoms on daily life, and overall well being compared was also improved after 3 and 6 weeks with citalopram.
There was only a modest effect on stool pattern.
Changes in depression or anxiety scores were not related to symptom improvement.
The team noted that the effect of acute administration of citalopram during a colonic barostat study did not predict clinical outcome.
The researchers confirmed the benefit of citalopram over placebo after the analysis of the first treatment period as a double blind parallel arm study.
Dr Tack's team concluded, “The selective serotonin reuptake inhibitors citalopram significantly improves irritable bowel syndrome symptoms, including abdominal pain, compared with placebo.”
“The therapeutic effect is independent of effects on anxiety, depression, and colonic sensorimotor function.”