Gastroenterologists should consider using psychotropic drugs in patients with functional dyspepsia, experts conclude after conducting a systematic review and meta-analysis of the evidence.

Professor Nick Talley from the University of Newcastle in NSW and colleagues analysed the evidence from 13 randomised controlled trials.

They found psychotropic drugs were more effective than placebo for the treatment of functional dyspepsia, with a number needed to treat of 6 (95% CI 4 to 16).

However the beneficial effect was limited to antipsychotic drugs such as sulpiride and levosulpiride, and tricyclic antidepressants such as amitriptyline and imipramine, they reported in Gut.

Adverse events were more common with a number needed to harm of 21 (95% CI 9 to 597).

Until now efforts to summarise the evidence have been hampered by a paucity of trials and a failure to extractable and dichotomous data, the researchers noted.

As a result current national guidelines for the management of FD were equivocal concerning the role of psychotropic drugs in FD.

“This underlines the importance of the current meta-analysis which has highlighted that antipsychotic drugs and TCADs are more effective than placebo in patients with FD” they said.

The findings have implications for the management of a condition that clinicians often find challenging, and should encourage appropriate use of these agents by gastroenterologists, they concluded.