Selective Serotonin Reuptake Inhibitors for the Treatment of Hypersensitive Esophagus: A Randomized, Double-Blind, Placebo-Controlled Study

Abstract

Treatment with SSRIs is effective in a select group of patients with hypersensitive esophagus.

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

“…[17][18][19][20][21][22][23][24] For the treatment of heartburn this percentage ranged from 23% to 61%. [26][27][28][29] Unfortunately, considerable differences between the selected studies regarding the patient definition, outcome definition, and the method of symptom analysis hampered the meta-analysis of the data presented.…”

“…[26][27][28][29] Viazis et al 26 identified 75 patients with a hypersensitive esophagus among a group of 252 patients with proton pump inhibitor (PPI)-refractory reflux symptoms. Although these patients showed physiological acid exposure during a 24-hour pH-impedance measurement, Ten milligrams during the first week, followed by 25 mg during weeks 2 and 3.…”

“…30 In a randomized, double-blind study, 6 months of treatment with 20 mg citalopram once a day was significantly more efficient in treating reflux symptoms than placebo because 38.5% of patients using citalopram reported remaining symptoms vs 66.7% of patients using placebo. 26 The most frequently remaining symptom was heartburn, followed by regurgitation and chest pain. A limitation of this study was that the presence of symptoms was not assessed using validated questionnaires or diaries but was based on physician reports.…”

Optimal treatment of laryngopharyngeal reflux disease

“…tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs)] decrease the perception of reflux episodes increasing the esophageal perception threshold [Broekaert et al 2006;Clouse et al 1987;Peghini et al 1998], thus may induce beneficial effects in patients with hypersensitive esophagus, as diagnosed through reflux monitoring in the case of normal acid exposure time and positive correlation between symptoms and refluxes [Viazis et al 2011]. These observations, although preliminary in nature, encourage the performance of studies aimed at assessing the efficacy of visceral pain modulators in patients with LPRD refractory to an optimal treatment with PPIs.…”

Reflux Hypersensitivity: A New Functional Esophageal Disorder

“…At the end of the follow-up period which lasted 6 months, 38.5% of the patients receiving citalopram and 66.7% of those receiving placebo continued to report heartburn symptoms (P = 0.021). 42 The study suggested that citalopram was effective in controlling heartburn in patients with reflux hypersensitivity. SSRIs have only 5-hydroxytryptamine activity and thus have less side effects as compared with TCAs.…”