Comparison of psychotropic drugs for functional dyspepsia

This network meta-analysis comparing various psychotropic medicines to treat functional dyspepsia found flupentixol + melitracen to be most effective in relieving dyspepsia symptoms, followed by tandospirone, imipramine, and amitriptyline.

To distinguish the relative effectiveness of various psychotropic/psychiatric drugs for the treatment of adults with functional dyspepsia (FD).

Database searching included exploring Embase, PubMed, and Cochrane Library, and thereby a network meta-analysis was conducted on the search results. Treatment efficacy was based on the number of patients who had a definite percentage reduction in FD symptoms or who plunged below the limit of the global overall symptom scores were considered as the primary outcome. The secondary endpoint was acceptability, defined as all-cause withdrawal. 

As found, ten trials were eligible for analysis, which included 970 patients with FD and ten psychotropic medicines. A combination of flupentixol + melitracen (F + M), tandospirone, imipramine, and amitriptyline were found to be considerably better compared to the placebo.

As per surface under the cumulative ranking curve (SUCRA), the most effective and least effective treatments were F plus M (89.0%) and R137696 (13.6%), respectively. Concerning acceptability, escitalopram was graded as the worst medicine (12.6%), which was followed by imipramine and sertraline.

F + M, tandospirone, imipramine, and amitriptyline are effective psychiatric medicines for adult patients with FD.