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[Antidepressant therapy in functional gastrointestinal disorders].
M Bixquert-Jiménez1, L Bixquert-Pla
1Servicio de Digestivo, Hospital Arnau de Vilanova, Valencia, Spain. miguel.bixquert@uv.es
Gastroenterologia Y Hepatologia
|September 28, 2005
Summary
Antidepressants can effectively treat pain in functional gastrointestinal disorders (FGD) by modulating nerves, independent of mood effects. Tricyclic antidepressants show particular promise for irritable bowel syndrome abdominal pain.
Area of Science:
- Gastroenterology and Pharmacology
- Neuroscience
Context:
- Functional gastrointestinal disorders (FGD) are frequently associated with anxiety and depression.
- Psychotropic drugs, particularly antidepressants, are increasingly explored for FGD treatment.
- Evidence for antidepressant efficacy in FGD is recent and limited.
Purpose:
- To review the therapeutic efficacy of psychotropic drugs, specifically antidepressants, in functional gastrointestinal disorders (FGD).
- To evaluate the antinociceptive mechanisms and clinical evidence for antidepressant use in FGD.
Summary:
- Antidepressants, even at sub-antidepressant doses, exert antinociceptive effects via central and peripheral neuromodulation, mediated by alpha-adrenoreceptors.
- Tricyclic antidepressants (TCAs) demonstrate greater analgesic activity than selective serotonin reuptake inhibitors (SSRIs).
- TCAs are effective for non-coronary chest pain and irritable bowel syndrome (IBS) abdominal pain, with significant efficacy and safety profiles.
Impact:
- Antidepressants offer a viable treatment option for specific FGD-related pain conditions.
- Demonstrates the potential of non-antidepressant effects of these drugs in pain management.
- Highlights the need for careful selection based on efficacy and adverse effect profiles, particularly avoiding hypotension and cardiotoxicity.