Gallbladder emptying in patients with major depression: a case series

Area of Science:

• Gastroenterology
• Pharmacology
• Psychiatry

Background:

• Antidepressants are known to cause gastrointestinal side effects.
• The impact of antidepressants on gallbladder motility remains uninvestigated.
• Major depression is a prevalent condition often treated with antidepressants.

Purpose of the Study:

• To investigate the effects of commonly prescribed antidepressants on gallbladder emptying.
• To compare gallbladder motility in patients with major depression taking amitriptyline, maprotiline, or fluoxetine versus a control group.
• To identify antidepressants that do not adversely affect gallbladder function.

Main Methods:

• An open clinical trial involving 112 patients with major depression.
• Gallbladder volume was measured using ultrasonography after a standardized test meal.
• Patients were divided into four groups: control (no antidepressants), amitriptyline, maprotiline, and fluoxetine.

Main Results:

• Amitriptyline significantly impaired gallbladder emptying, indicated by a higher mean residual volume (11.0±6.1 mL) one hour post-meal.
• Gallbladder emptying was complete in the control group and in patients taking maprotiline or fluoxetine (mean residual volumes 5.0±3.3 mL, 5.6±3.7 mL, and 5.7±2.3 mL, respectively).
• Statistical analysis confirmed a significant difference in gallbladder emptying among the groups (F=10.829, p=0.000).

Conclusions:

• Amitriptyline use is associated with impaired gallbladder emptying in patients with major depression.
• Maprotiline and fluoxetine do not appear to negatively impact gallbladder motility.
• For patients with cholecystitis, selecting antidepressants like maprotiline or fluoxetine over amitriptyline is recommended to preserve gallbladder function.