Paroxetine to Treat Irritable Bowel Syndrome Not Responding to High-Fiber Diet: A Double-Blind, Placebo-Controlled Trial

Tabas, Gary; Beaves, Mary; Wang, Jiping; Friday, Paul C.; Mardini, Houssam; Arnold, G

doi:10.1111/j.1572-0241.2004.04127.x

Cited by 160 publications

(111 citation statements)

References 14 publications

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“…It may be that specific subgroups of patients with functional dyspepsia, such as those with co-morbid anxiety or depression, would do well on one or both of these agents. Other evidence suggests that antidepressant therapy may improve global well-being rather than specific gastrointestinal symptoms in irritable bowel syndrome [22], and this could not be assessed in the current study model. However, any benefit of these drug classes in functional dyspepsia remains to be established by appropriately conducted, randomized, controlled trials.…”

Section: Discussioncontrasting

confidence: 40%

Effects of Desipramine and Escitalopram on Postprandial Symptoms Induced by the Nutrient Drink Test in Healthy Volunteers: A Randomized, Double-Blind, Placebo-Controlled Study

et al. 2005

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Background: Antidepressants are widely used to treat functional gastrointestinal disorders but their effect on postprandial symptoms remains unstudied. We hypothesized that desipramine and escitalopram would enhance the maximum tolerated volume of nutrient ingested and decrease postprandial symptoms. Methods: Healthy participants (n = 45) all underwent an assessment of symptoms, anxiety and depression, and a standard nutrient drink test (Ensure). Participants were randomized to 11 days of desipramine (50 mg once daily), escitalopram (10 mg once daily) or identical placebo. Results: The maximum tolerated gastric volumes were not significantly different on day 11 for desipramine (1,136 ± 478 ml, mean ± SD), escitalopram (1,198 ± 422 ml) and placebo (1,231 ± 318 ml). A univariate analysis indicated significant treatment group effects on total symptom scores (p = 0.049), but after adjusting for age, gender, BMI and baseline scores, treatment effects were no longer significant (p = 0.15). Conclusions: While this study does not rule out a beneficial effect of tricyclics or selective serotonin reuptake inhibitors in functional dyspepsia, neither desipramine nor escitalopram significantly altered the nutrient volume ingested or symptoms induced by the nutrient drink test in healthy volunteers.

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Section: Discussioncontrasting

confidence: 40%

Effects of Desipramine and Escitalopram on Postprandial Symptoms Induced by the Nutrient Drink Test in Healthy Volunteers: A Randomized, Double-Blind, Placebo-Controlled Study

et al. 2005

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“…Fewer studies have been conducted with SSRIs. In one randomized-controlled trial comparing paroxetine (10-40 mg/d) to placebo, patients treated with the SSRI reported a significant improvement in overall wellbeing, but did not experience improvement in abdominal pain [118] . Other studies with paroxetine have shown an improvement in abdominal pain and discomfort, and suggest that further studies with this class of medication are needed [119,120] .…”

Section: Antidepressantsmentioning

confidence: 99%

Updates on treatment of irritable bowel syndrome

Hammerle¹,

Surawicz²

2008

WJG

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Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits. It is estimated to affect 10%-15% of the Western population, and has a large impact on quality of life and (in)direct healthcare costs. IBS is a multifactorial disorder involving dysregulation within the brain-gut axis, and it is frequently associated with gastrointestinal motor and sensory dysfunction, enteric and central nervous system irregularities, neuroimmune dysregulation, and postinfectious inflammation. As with other functional medical disorders, the treatment for IBS can be challenging. Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory, and the development of new and effective drugs is made difficult by the complex pathogenesis, variety of symptoms, and lack of objective clinical findings that are the hallmark of this disorder. Fortunately, research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS, and have led to the development of several promising pharmaceutical agents. In recent years there has been much publicity over several of these new IBS medications (alosetron and tegaserod) because of their reported association with ischemic colitis and cardiovascular disease. While these agents remain available for use under restricted prescribing programs, this highlights the need for continued development of safe and effective medication for IBS. This article provides a physiologicallybased overview of recently developed and frequently employed pharmaceutical agents used to treat IBS, and discusses some non-pharmaceutical options that may be beneficial in this disorder.

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“…SSRIs may improve visceral hypersensitivity, particularly in constipationpredominant IBS, although the effi cacy of this class of medications continues to be debated [168,169] . Finally, SSRIs have been shown to improve patients' sense of well-being, even in non-depressed patients [170] .…”

Section: Irritable Bowel Syndromementioning

confidence: 99%

Gastrointestinal Motility Disorders: An Update

Lacy

Weiser

2006

Dig Dis

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Gastrointestinal motility disorders encompass a wide array of signs and symptoms that can occur anywhere throughout the luminal gastrointestinal tract. Motility disorders are often chronic in nature and dramatically affect patients’ quality of life. These prevalent disorders cause a tremendous impact both to the individual patient and to society as a whole. Significant progress has been made over the last 5 years in understanding the etiology and pathophysiology of gastrointestinal motility disorders. This clinical update will focus on seven of the most common gastrointestinal motility disorders (achalasia, non-achalasia esophageal motility disorders, dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction, irritable bowel syndrome, and chronic constipation) with an emphasis on current treatment options and new therapeutic modalities.

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Paroxetine to Treat Irritable Bowel Syndrome Not Responding to High-Fiber Diet: A Double-Blind, Placebo-Controlled Trial

Abstract: The difference in overall well-being found in our paroxetine/placebo trial is greater than that found in previously published drug/placebo trials for IBS. Moreover, the difference in well-being applied to nondepressed recipients of paroxetine.

Cited by 160 publications

References 14 publications

Effects of Desipramine and Escitalopram on Postprandial Symptoms Induced by the Nutrient Drink Test in Healthy Volunteers: A Randomized, Double-Blind, Placebo-Controlled Study

Effects of Desipramine and Escitalopram on Postprandial Symptoms Induced by the Nutrient Drink Test in Healthy Volunteers: A Randomized, Double-Blind, Placebo-Controlled Study

Updates on treatment of irritable bowel syndrome

Gastrointestinal Motility Disorders: An Update

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