Digestive Diseases and Sciences

, Volume 53, Issue 1, pp 108–115 | Cite as

Antidepressant Therapy (Imipramine and Citalopram) for Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Trial

  • Nicholas J. TalleyEmail author
  • John E. Kellow
  • Philip Boyce
  • Christopher Tennant
  • Sandy Huskic
  • Michael Jones
Original Paper



The efficacy of antidepressants in irritable bowel syndrome (IBS) is controversial. No trials have directly compared a tricyclic with a selective serotonin reuptake inhibitor. Our aim was to determine whether imipramine and citalopram are efficacious in IBS.


This was a randomized, double-blind, placebo-controlled, parallel group pilot trial with imipramine (50 mg) and citalopram (40 mg).


Of 51 IBS patients randomized, baseline characteristics were comparable among the treatment arms; the majority was diarrhea-predominant. Adequate relief of IBS symptoms (primary endpoint) was similar for each treatment arm. Improvements in bowel symptom severity rating for interference (P = 0.05) and distress (P = 0.02) were greater with imipramine versus placebo, but improvements in abdominal pain were not. There was a greater improvement in depression score (P = 0.08) and in the SF-36 Mental Component Score (P = 0.07), with imipramine. Citalopram was not superior to placebo. Approximately 20% of the variance in scores was explained by treatment differences for abdominal pain, bowel symptom severity disability, depression and the mental component of the SF-36.


Neither imipramine nor citalopram significantly improved global IBS endpoints over placebo.


Antidepressant Irritable bowel syndrome Randomized trial 



This work was supported by the National Health and Medical Research Council of Australia (Dr. Talley, PI). Citalopram was provided free of charge for the study by Lundbeck Australia Pty Ltd. Imipramine was provided free of charge for this study by Novartis Pharmaceuticals Australia Pty Ltd.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Nicholas J. Talley
    • 1
    • 2
    Email author
  • John E. Kellow
    • 4
  • Philip Boyce
    • 5
  • Christopher Tennant
    • 3
  • Sandy Huskic
    • 1
  • Michael Jones
    • 6
  1. 1.Department of Medicine, Nepean HospitalUniversity of SydneySydneyAustralia
  2. 2.Clinical Enteric Neuroscience Translational and Epidemiological Research ProgramMayo Clinic College of MedicineRochesterUSA
  3. 3.Department of Psychological MedicineRoyal North Shore HospitalSydneyAustralia
  4. 4.Department of MedicineRoyal North Shore Hospital, University of SydneySydneyAustralia
  5. 5.Department of Psychological MedicineWestmead HospitalSydneyAustralia
  6. 6.Psychology DepartmentMacquarie UniversityNorth RydeAustralia

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