Antidepressants may improve symptoms in patients with inflammatory bowel disease

1. In this systematic review and meta-analysis, patients with inflammatory bowel disease (IBD) who took antidepressants had lower anxiety, depression, and IBD disease activity scores than control groups.

2. In addition, patients who received antidepressants were more likely to reach clinical remission and had higher physical quality of life (QOL) and social QoL.

Evidence Rating Level: 1 (Excellent)

Inflammatory bowel disease (IBD) is often accompanied by psychiatric disorders such as anxiety and depression, which may significantly impact a patient’s quality of life (QoL). Currently, the efficacy of antidepressants in IBD patients is poorly understood. As a result, the objective of the present study was to synthesize new data on the effect of antidepressants on mental and physical health outcomes in patients with IBD.

Of 1,556 identified records, 13 (n=884) studies were included from various sources from database inception to July 2022. Randomized-controlled trials that investigated antidepressant use in individuals with IBD and reported outcomes relating to mental or physical health were included in the review. Studies were excluded if Chinese medicine was used for IBD treatment. The review was performed using PRISMA guidelines. Risk of bias was assessed using the Cochrane risk of bias tool. The primary outcomes were depression and anxiety scores.

The results demonstrated that antidepressants significantly improved depression and anxiety scores in IBD patients. With respect to secondary outcomes, antidepressants reduced IBD disease activity scores and helped induce clinical remission. Patients also reported higher physical QoL and social QoL with antidepressant use. Despite these results, the study was limited by the inclusion of some patients with IBD who had previously used antidepressants or who had other psychiatric conditions. Nonetheless, the present study demonstrated evidence of the effect of antidepressants in improving mental and physical health in IBD patients.

Click to read the study in Therapeutic Advances in Gastroenterology

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