Neuromodulating agents in functional dyspepsia: a comprehensive review

Functional dyspepsia is a frequent chronic condition characterized by upper abdominal discomfort without an identifiable organic cause. Usual first-line treatments include proton pump inhibitors or Helicobacter pylori eradication, but many patients continue to have persistent symptoms. Because of this, neuromodulating agents are frequently used in clinical practice, although current European, American and Canadian guidelines primarily mention tricyclic antidepressants (TCAs).

This review analyzed randomized controlled trials in adults meeting Rome criteria or with normal endoscopy findings. Out of 386 studies screened, 14 met inclusion criteria.

The findings indicate that TCAs, such as amitriptyline and imipramine, show the strongest evidence of benefit for symptom relief in functional dyspepsia. Other agents, including tetracyclic antidepressants, levosulpiride, and anxiolytics, may be helpful, but current data are insufficient to draw firm conclusions. By contrast, SSRIs and SNRIs do not appear effective for this condition.

Learn more about this review here: https://doi.org/10.51821/86.1.10998


Reference

Bosman, L., Wauters, L., & Vanuytsel, T. (2023). Neuromodulating agents in functional dyspepsia: a comprehensive review. Acta gastro-enterologica Belgica86(1), 49–57