.: DERLEME
Antidepresanların Fonksiyonel Üst Gastrointestinal Hastalıkların Tedavisindeki Yeri
Use of Antidepressants for Treating Functional Upper Gastrointestinal Disorders
Turkiye Klinikleri J Intern Med. 2019;4(1):25-31
doi: 10.5336/intermed.2018-63295
Makale Dili: TR
Tam Metin
Ücretsiz Erişim
ÖZET
Fonksiyonel üst gastrointestinal hastalıklar ile gastroenteroloji ve dâhiliye pratiğinde sıklıkla karşılaşılmaktadır. Bu hastalıklar; kişilerin sosyal ve aile yaşantısını etkilemekte, azalmış hayat kalitesi ve artmış sağlık harcamalarına neden olmaktadır. Fonksiyonel gastrointestinal hastalıkların patogenezinde; periferik mekanizmaların yanında, santral mekanizmalar da rol oynamaktadır. Beyin ile bağırsak arasındaki bu ilişkide görev alan nörotransmitter ve reseptörler fonksiyonel hastalıkların tedavisinde hedef hâline gelmiş ve psikotrop ilaçlar fonksiyonel gastrointestinal hastalıkların tedavisinde yerini almıştır. Bu çalışmada; fonksiyonel üst gastrointestinal hastalıklarının tanımı, tanı kriterleri ve tedavi seçeneklerinin güncel literatür verileri ışığında özetlenmesi ve mevcut kanıtlar ve gözlemler çerçevesinde bu hastalara yaklaşım ve uygun antidepresan seçiminde rehber olması amaçlanmıştır.
Anahtar Kelimeler: Fonksiyonel üst gastrointestinal hastalıklar; antidepresan
Fonksiyonel üst gastrointestinal hastalıklar ile gastroenteroloji ve dâhiliye pratiğinde sıklıkla karşılaşılmaktadır. Bu hastalıklar; kişilerin sosyal ve aile yaşantısını etkilemekte, azalmış hayat kalitesi ve artmış sağlık harcamalarına neden olmaktadır. Fonksiyonel gastrointestinal hastalıkların patogenezinde; periferik mekanizmaların yanında, santral mekanizmalar da rol oynamaktadır. Beyin ile bağırsak arasındaki bu ilişkide görev alan nörotransmitter ve reseptörler fonksiyonel hastalıkların tedavisinde hedef hâline gelmiş ve psikotrop ilaçlar fonksiyonel gastrointestinal hastalıkların tedavisinde yerini almıştır. Bu çalışmada; fonksiyonel üst gastrointestinal hastalıklarının tanımı, tanı kriterleri ve tedavi seçeneklerinin güncel literatür verileri ışığında özetlenmesi ve mevcut kanıtlar ve gözlemler çerçevesinde bu hastalara yaklaşım ve uygun antidepresan seçiminde rehber olması amaçlanmıştır.
Anahtar Kelimeler: Fonksiyonel üst gastrointestinal hastalıklar; antidepresan
ABSTRACT
Functional upper gastrointestinal disorders are very common both in gastroenterology and internal medicine practice. They are associated with significant distress in social and family lives of subjects, reduced quality of life, and increased health care costs. Abnormal peripheral sensitization and central processing are considered in the pathogenesis of functional gastrointestinal disorders (FGID). Psychotropic agents are increasingly used for treatment of FGIDs, now recognized as disorders of gut-brain interaction. However, the available evidence and guidance for the use of psychotropic agents in these conditions are limited. We aimed to summarize current concepts on definiton, diagnosis, and treatment options for FGIDs and to provide recommendations for the management of these patients and the choice of appropriate antidepressants.
Keywords: Functional upper gastrointestinal disorders; antidepressant
Functional upper gastrointestinal disorders are very common both in gastroenterology and internal medicine practice. They are associated with significant distress in social and family lives of subjects, reduced quality of life, and increased health care costs. Abnormal peripheral sensitization and central processing are considered in the pathogenesis of functional gastrointestinal disorders (FGID). Psychotropic agents are increasingly used for treatment of FGIDs, now recognized as disorders of gut-brain interaction. However, the available evidence and guidance for the use of psychotropic agents in these conditions are limited. We aimed to summarize current concepts on definiton, diagnosis, and treatment options for FGIDs and to provide recommendations for the management of these patients and the choice of appropriate antidepressants.
Keywords: Functional upper gastrointestinal disorders; antidepressant
REFERANSLAR:
- Aydin N, Cetin M, Kurt E, Savas H, Acıkel C, Kilic S, et al. A report by Turkish association for psychopharmacology on the psychotropic drug usage in Turkey and medical, ethical and economical consequences of current applications. Bulletin of Clinical Psychopharmacology. 2013;23(4):390-402. [Crossref ]
- Drossman DA. Biopsychosocial issues in gastroenterology. In: Feldman M, Lawrence S, Lawrence JB, eds. Sleisenger and Fordtran?s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia: Elsevier; 2016. p.349-62.
- Van Oudenhove L, Crowell MD, Drossman DA, Halpert AD, Keefer L, Lackner JM, et al. Biopsychosocial aspects of functional gastrointestinal disorders. Gastroenterology. 2016;150(6):1355-67. [Crossref ] [PubMed]
- Sobin WH, Heinrich TW, Drossman DA. Central neuromodulators for treating functional GI disorders: a primer. Am J Gastroenterol. 2017;112(5):693-702. [Crossref ] [PubMed]
- Tack J, Ly HG, Carbone F, Vanheel H, Vanuytsel T, Holvoet L, et al. Efficacy of mirtazapine in patients with functional dyspepsia and weight loss. Clin Gastroenterol Hepatol. 2016;14(3):385-92 .e4.
- Aziz Q, Fass R, Gyawali CP, Miwa H, Pandolfino JE, Zerbib F. Functional esophageal disorders. Gastroenterology. 2016;150(6): 1368-79. [Crossref ] [PubMed]
- Stanghellini V, Chan FK, Hasler WL, Malagelada JR, Suzuki H, Tack J, et al. Gastroduodenal disorders. Gastroenterology. 2016; 150(6):1380-92. [Crossref ] [ PubMed]
- Fass R, Fennerty MB, Ofman JJ, Gralnek IM, Johnson C, Camargo E, et al. The clinical and economic value of a short course of omeprazole in patients with noncardiac chest pain. Gastroenterology. 1998;115(1):42-9. [Cross - ref ]
- Dickman R, Maradey-Romero C, Fass R. The role of pain modulators in esophageal disorders -no pain no gain. Neurogastroenterol Motil. 2014;26(5):603-10. [Crossref] [PubMed]
- Varia I, Logue E, O?Connor C, Newby K, Wagner HR, Davenport C, et al. Randomized trial of sertraline in patients with unexplained chest pain of noncardiac origin. Am Heart J. 2000;140(3):367-72. [Crossref ] [PubMed]
- Park SW, Lee H, Lee HJ, Park JC, Shin SK, Lee SK, et al. Low-dose amitriptyline combined with proton pump inhibitor for functional chest pain. World J Gastroenterol. 2013;19(30):4958-65. [Crossref] [PubMed] [PMC]
- Lee H, Kim JH, Min BH, Lee JH, Son HJ, Kim JJ, et al. Efficacy of venlafaxine for sympto matic relief in young adult patients with functional chest pain: a randomized, double-blind, placebo-controlled, crossover trial. Am J Gastroenterol. 2010;105(7):1504-12. [Crossref] [PubMed]
- Ostovaneh MR, Saeidi B, Hajifathalian K, Farrokhi-Khajeh-Pasha Y, Fotouhi A, Mirbagheri SS, et al. Comparing omeprazole with fluoxetine for treatment of patients with heartburn and normal endoscopy who failed once daily proton pump inhibitors: doubleblind placebo-controlled trial. Neurogastroenterol Motil. 2014;26(5):670-8. [Crossref ] [PubMed]
- Chua YC, Ng KS, Sharma A, Jafari J, Surguy S, Yazaki E, et al. Randomised clinical trial: pregabalin attenuates the development of acid-induced oesophageal hypersensitivity in healthy volunteers -a placebo-controlled study. Aliment Pharmacol Ther. 2012;35(3): 319-26. [Crossref ] [PubMed]
- Viazis N, Keyoglou A, Kanellopoulos AK, Karamanolis G, Vlachogiannakos J, Triantafyllou K, et al. Selective serotonin reuptake inhibitors for the treatment of hypersensitive esophagus: a randomized, double-blind, placebo-controlled study. Am J Gastroenterol. 2012;107(11):1662-7. [Cross ref ] [PubMed]
- Peghini PL, Katz PO, Castell DO. Imipramine decreases oesophageal pain perception in human male volunteers. Gut. 1998;42(6):807-13. [Crossref ] [PubMed] [PMC]
- Limsrivilai J, Charatcharoenwitthaya P, Pausawasdi N, Leelakusolvong S. Imipramine for treatment of esophageal hypersensitivity and functional heartburn: a randomized placebo-controlled trial. Am J Gastroenterol. 2016;111(2):217-24. [Cross ref] [ PubMed]
- You LQ, Liu J, Jia L, Jiang SM, Wang GQ. Effect of low-dose amitriptyline on globus pharyngeus and its side effects. World J Gastroenterol. 2013;19(42):7455-60. [Crossref] [PubMed] [PMC]
- Chen DY, Jia L, Gu X, Jiang SM, Xie HL, Xu J. Comparison of paroxetine and amitriptyline in the treatment of refractory globus pharyngeus. Dig Liver Dis. 2016;48(9):1012-7. [Crossref] [PubMed]
- Zhou WC, Jia L, Chen DY, Liu Y, Liu J, Jiang SM, et al. The effects of paroxetine and amitriptyline on the upper esophageal sphincter (UES) pressure and its natural history in globus pharyngeus. Dig Liver Dis. 2017;49(7):757-63. [Crossref ] [PubMed]
- Colon VJ, Young MA, Ramirez FC. The shortand long-term efficacy of empirical esophageal dilation in patients with nonobstructive dysphagia: a prospective, randomized study. Am J Gastroenterol. 2000;95(4): 910-3. [Crossref ] [PubMed]
- Tack J, Broekaert D, Coulie B, Fischler B, Janssens J. Influence of the selective serotonin re-uptake inhibitor, paroxetine, on gastric sensorimotor function in humans. Aliment Pharmacol Ther. 2003;17(4):603-8. [Crossref] [PubMed]
- Distrutti E, Fiorucci S, Hauer SK, Pensi MO, Vanasia M, Morelli A. Effect of acute and chronic levosulpiride administration on gastric tone and perception in functional dyspepsia. Aliment Pharmacol Ther. 2002;16(3):613-22. [Crossref] [PubMed]
- Ford AC, Luthra P, Tack J, Boeckxstaens GE, Moayyedi P, Talley NJ. Efficacy of psychotropic drugs in functional dyspepsia: systematic review and meta-analysis. Gut. 2017;66(3):411-20. [Crossref ] [PubMed]
- Song CW, Chun HJ, Kim CD, Ryu HS, Choe JG, Hyun JH. Effects of levosulpiride in patients with functional dyspepsia accompanied by delayed gastric emptying. Korean J Intern Med. 1998;13(1):15-21. [Crossref] [PubMed] [PMC]
- Talley NJ, Locke GR, Saito YA, Almazar AE, Bouras EP, Howden CW, et al. Effect of amitriptyline and escitalopram on functional dyspepsia: a multicenter, randomized controlled study. Gastroenterology. 2015; 149(2):340-9.e2. [Crossref ] [PubMed] [PMC]
- Patel A, Sayuk GS, Kushnir VM, Gyawali CP. Sensory neuromodulators in functional nausea and vomiting: predictors of response. Postgrad Med J. 2013;89(1049):131-6. [Crossref] [PubMed] [PMC]
- Clouse RE, Sayuk GS, Lustman PJ, Prakash C. Zonisamide or levetiracetam for adults with cyclic vomiting syndrome: a case series. Clin Gastroenterol Hepatol. 2007;5(1):44-8. [Crossref] [PubMed]
- Prakash C, Lustman PJ, Freedland KE, Clouse RE. Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients. Dig Dis Sci. 1998;43(9):1951-6. [Crossref] [PubMed]
- Coskun M, Alyanak B. Psychiatric co-morbidity and efficacy of mirtazapine treatment in young subjects with chronic or cyclic vomiting syndromes: a case series. J Neurogastroenterol Motil. 2011;17(3):305-11. [Crossref] [PubMed ] [PMC]
.: İşlem Listesi