Efficacy of tandospirone in patients with irritable bowel syndrome-diarrhea and anxiety

Lan, Ling; Chen, Yulong; Zhang, Hao; Ji, Bing; Chu, Yanqi; Shixiao, Tang; Xia, Guodong

doi:10.3748/wjg.v20.i32.11422

Cited by 17 publications

(13 citation statements)

References 31 publications

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“…231,232 When the same agent was used in patients with IBS and anxiety, the fraction of patients responding with at least 50% decrease in pain was significantly higher than that in the placebo group. 233 A recent meta-analysis of controlled trials in depression showed a relatively high incidence of adverse effects on gastrointestinal function, which could contribute to these discrepancies. 234 …”

Section: Buspirone In Ibdmentioning

confidence: 98%

Empirically Supported Use of Psychiatric Medications in Adolescents and Adults with IBD

Thorkelson

Bielefeldt

Szigethy

2016

Inflammatory Bowel Diseases

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Antidepressant medications are frequently prescribed for depression, anxiety disorders, and chronic pain syndromes, but overall support for their efficacy is modest at best. Psychological interventions have growing support for having much more robust effects without the side effects of antidepressants and should be considered first-line treatment or at least an adjunct to psychotropic medications for these conditions.

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Section: Buspirone In Ibdmentioning

confidence: 98%

Empirically Supported Use of Psychiatric Medications in Adolescents and Adults with IBD

Thorkelson

Bielefeldt

Szigethy

2016

Inflammatory Bowel Diseases

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“…Tandospirone is available only in China and Japan. Positive effects on abdominal pain ratings (≥ 50% reduction compared with baseline) among IBS patients were reported in a study confounded by simultaneous use of pinaverium [ 51 ], but it was not better than placebo in a study involving patients with functional dyspepsia [ 52 ]. With these data at hand, the clinical recommendation for buspirone is to use it when early satiety, fullness, and nausea dominate a DGBI.…”

Section: Central Neuromodulatorsmentioning

confidence: 99%

Psychotropics, Antidepressants, and Visceral Analgesics in Functional Gastrointestinal Disorders

Törnblom

Drossman

2018

Curr Gastroenterol Rep

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Purpose of ReviewThe functional gastrointestinal disorders, or disorders of gut-brain interaction as defined by the Rome IV criteria, are the most common diagnostic entities in gastroenterology. Treatments that address the dysregulation of gut-brain interaction with these disorders are increasingly gaining interest as a better option than for example traditional analgesics, particularly opioids. Antidepressants, antianxiety and antipsychotic medications, and visceral analgesics, now termed neuromodulators, are included in this update addressing the evidence of treatment benefit in disorders of brain-gut interaction.Recent FindingsBy a careful selection based on a multidimensional clinical profile, a decreased symptom burden, particularly regarding abdominal pain, nausea, and vomiting, as well as improved social function and quality of life, can be obtained by use of neuromodulators. There is good evidence for the peripheral neuromodulators from studies in bowel disorders, and the central neuromodulators both from indirect evidence in chronic pain disorders as well as selected disorders of brain-gut interaction.SummaryBasic knowledge about the pharmacologic properties and clinical use of neuromodulators in disorders of brain-gut interaction improves the treatment outcome and avoids use of traditional analgesics.

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“…The effect of central 5-hydroxytryptamine (5-HT) and its receptor, 5-HT1A receptor (HTR1A), on perception and processing of pain have become increasingly recognized over time. For example, HTR1A has been associated with chronic stress-induced visceral hypersensitivity and neuropathic pain in pre-clinical rodent studies, and many clinical trials have suggested that activation of HTR1A (either directly or via 5-HT reuptake inhibition) in the CNS might ameliorate psychiatric and gastrointestinal symptoms of IBS [15,16]. Recently, down-regulation of HTR1A in some nuclei of the limbic system (including the ACC and IC) was observed in rats with viseral hypersensitivity induced by chronic water avoidance stress (WAS), and local up-regulation of HTR1A using lentiviral constructs or direct activation with a selective agonist could reverse the visceral hypersensitivity and anxiety-like behaviours [17,18].…”

Section: Introductionmentioning

confidence: 99%

Up-regulation of HTR1A reverses stress-induced visceral hypersensitivity through modulating interactions among the anterior cingulate cortex, insular cortex and hippocampus

Xuan

Zhou

et al. 2020

Pteridines

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Background: This study aimed to explore the effect of 5-HT1A receptors (HTR1A) on activation of the anterior cingulate cortex and simultaneous regulation of neural activity in the insular cortex and hippocampus.Methods: The IBS rat model was established via chronic water avoidance stress (WAS). Visceral sensitivity was measured by electromyogram, and anxiety-like behaviours were evaluated by the open field test. HTR1A-specific lentivirus expressing green fluorescent protein was used to overexpress or down-regulate HTR1A expression. Protein expression levels were detected by western blot.Results: Up-regulation of HTR1A in ACC could inhibit ACC sensitization and reverse the visceral hypersensitivity and anxiety-like behaviours induced by chronic psychological stress. In contrast, down-regulation of HTR1A in ACC might promote these behaviors in IBS rats. Additionally, up-regulation of HTR1A in ACC could inhibit IC and hippocampus sensitization, while down-regulation might have the opposite effect.Conclusions: In IBS rats, HTR1A could modulate ACC activation and interactions among the ACC, IC and hippocampus. These effects might in turn contribute to the development of visceral hypersensitivity and anxiety-like behaviours induced by chronic psychological stress.

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Efficacy of tandospirone in patients with irritable bowel syndrome-diarrhea and anxiety

Abstract: Tandospirone is effective and can be combined with pinaverium in IBS-D patients with anxiety.

Cited by 17 publications

References 31 publications

Empirically Supported Use of Psychiatric Medications in Adolescents and Adults with IBD

Empirically Supported Use of Psychiatric Medications in Adolescents and Adults with IBD

Psychotropics, Antidepressants, and Visceral Analgesics in Functional Gastrointestinal Disorders

Up-regulation of HTR1A reverses stress-induced visceral hypersensitivity through modulating interactions among the anterior cingulate cortex, insular cortex and hippocampus

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