Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: A Systematic Review

Weijenborg, Pim W.; Schepper, Heiko U. De; Smout, A. J. P. M.; Bredenoord, Albert J.

doi:10.1016/j.cgh.2014.06.025

Cited by 86 publications

(48 citation statements)

References 43 publications

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“…Furthermore, previous studies have demonstrated that GERD is more likely to be reported in patients with depression who are taking antidepressants, than those without . However, there is also some suggestion that low doses of antidepressants may be used in the treatment of GERD through their effects on visceral hypersensitivity . Our study demonstrated that antidepressant usage was not associated with likelihood of patients reporting GERD symptoms.…”

Section: Discussioncontrasting

confidence: 40%

The association between gastroesophageal reflux disease with sleep quality, depression, and anxiety in a cohort study of Australian men

Grant

Shi

et al. 2017

J of Gastro and Hepatol

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Section: Discussioncontrasting

confidence: 40%

The association between gastroesophageal reflux disease with sleep quality, depression, and anxiety in a cohort study of Australian men

Grant

Shi

et al. 2017

J of Gastro and Hepatol

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“…The lack of abnormal acid exposure and symptom-reflux association makes patients with functional heartburn not responsive to PPIs. This subgroup of subjects may benefit from visceral analgesics (e.g., antidepressants) [64]. …”

Section: Resultsmentioning

confidence: 99%

Effective and safe proton pump inhibitor therapy in acid-related diseases – A position paper addressing benefits and potential harms of acid suppression

Scarpignato

Gatta

Zullo³

et al. 2016

BMC Med

359

288

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BackgroundThe introduction of proton pump inhibitors (PPIs) into clinical practice has revolutionized the management of acid-related diseases. Studies in primary care and emergency settings suggest that PPIs are frequently prescribed for inappropriate indications or for indications where their use offers little benefit. Inappropriate PPI use is a matter of great concern, especially in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions. Herein, we aim to review the current literature on PPI use and develop a position paper addressing the benefits and potential harms of acid suppression with the purpose of providing evidence-based guidelines on the appropriate use of these medications.MethodsThe topics, identified by a Scientific Committee, were assigned to experts selected by three Italian Scientific Societies, who independently performed a systematic search of the relevant literature using Medline/PubMed, Embase, and the Cochrane databases. Search outputs were distilled, paying more attention to systematic reviews and meta-analyses (where available) representing the best evidence. The draft prepared on each topic was circulated amongst all the members of the Scientific Committee. Each expert then provided her/his input to the writing, suggesting changes and the inclusion of new material and/or additional relevant references. The global recommendations were then thoroughly discussed in a specific meeting, refined with regard to both content and wording, and approved to obtain a summary of current evidence.ResultsTwenty-five years after their introduction into clinical practice, PPIs remain the mainstay of the treatment of acid-related diseases, where their use in gastroesophageal reflux disease, eosinophilic esophagitis, Helicobacter pylori infection, peptic ulcer disease and bleeding as well as, and Zollinger–Ellison syndrome is appropriate. Prevention of gastroduodenal mucosal lesions (and symptoms) in patients taking non-steroidal anti-inflammatory drugs (NSAIDs) or antiplatelet therapies and carrying gastrointestinal risk factors also represents an appropriate indication. On the contrary, steroid use does not need any gastroprotection, unless combined with NSAID therapy. In dyspeptic patients with persisting symptoms, despite successful H. pylori eradication, short-term PPI treatment could be attempted. Finally, addition of PPIs to pancreatic enzyme replacement therapy in patients with refractory steatorrhea may be worthwhile.ConclusionsOverall, PPIs are irreplaceable drugs in the management of acid-related diseases. However, PPI treatment, as any kind of drug therapy, is not without risk of adverse effects. The overall benefits of therapy and improvement in quality of life significantly outweigh potential harms in most patients, but those without clear clinical indication are only exposed to the risks of PPI prescription. Adhering with evidence-based ...

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“…On the pharmacological side, the development of drugs that interfere with transient lower esophageal sphincter relaxation (the main mechanism of reflux regardless of its acidic content) has been stopped because of their unconvincing efficacy and side effects [16]. Furthermore, although it has been shown that antidepressants modulate esophageal sensation, they are not approved for GER disease because they have only been assessed in a few studies and further controlled trials are necessary [17]; they are therefore administered at the discretion of individual physicians. On the surgical side, although small short-term studies have shown the benefit of fundoplication in patients with symptoms related to WA reflux [18][19][20], long-term studies are needed, especially in consideration that this therapeutic option is not devoid of morbidity and mortality [21].…”

Section: Discussionmentioning

confidence: 99%

pH Impedance vs. traditional pH monitoring in clinical practice: an outcome study

et al. 2015

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Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: A Systematic Review

Cited by 86 publications

References 43 publications

The association between gastroesophageal reflux disease with sleep quality, depression, and anxiety in a cohort study of Australian men

The association between gastroesophageal reflux disease with sleep quality, depression, and anxiety in a cohort study of Australian men

Effective and safe proton pump inhibitor therapy in acid-related diseases – A position paper addressing benefits and potential harms of acid suppression

pH Impedance vs. traditional pH monitoring in clinical practice: an outcome study

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