Treatment of Functional Abdominal Pain With Antidepressants

Zar-Kessler, Claire; Belkind‐Gerson, Jaime; Bender, Suzanne L.; Kuo, Braden

doi:10.1097/mpg.0000000000001416

Cited by 20 publications

(9 citation statements)

References 34 publications

(38 reference statements)

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“…IBS treatment is the same across different age groups, yet medication side effects and polypharmacy can lead to cautious use in older adults. Patients treated with selective serotonin reuptake inhibitors had significantly higher response and improvement in their IBS symptoms when compared to the group treated with tricyclic antidepressants (TCA) [159]. TCA and antispasmodic medications can exacerbate urinary retention, closed angle glaucoma, and cognitive impairment in elderly secondary to their anticholinergic properties.…”

Section: Large Intestinementioning

confidence: 99%

Gastrointestinal Tract Disorders in Older Age

Dumić

Nordin

Jecmenica

et al. 2019

Canadian Journal of Gastroenterology and Hepatology

184

111

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Considering an increase in the life expectancy leading to a rise in the elderly population, it is important to recognize the changes that occur along the process of aging. Gastrointestinal (GI) changes in the elderly are common, and despite some GI disorders being more prevalent in the elderly, there is no GI disease that is limited to this age group. While some changes associated with aging GI system are physiologic, others are pathological and particularly more prevalent among those above age 65 years. This article reviews the most important GI disorders in the elderly that clinicians encounter on a daily basis. We highlight age-related changes of the oral cavity, esophagus, stomach, small and large bowels, and the clinical implications of these changes. We review epidemiology and pathophysiology of common diseases, especially as they relate to clinical manifestation in elderly. Details regarding management of specific disease are discussed in detail if they significantly differ from the management for younger groups or if they are associated with significant challenges due to side effects or polypharmacy. Cancers of GI tract are not included in the scope of this article.

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Section: Large Intestinementioning

confidence: 99%

Gastrointestinal Tract Disorders in Older Age

Dumić

Nordin

Jecmenica

et al. 2019

Canadian Journal of Gastroenterology and Hepatology

184

111

View full text Add to dashboard Cite

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“…A recent retrospective, single-tertiary-care-center study that investigated treatment efficacy of antidepressant use in pediatric FAP found a significantly greater response to SSRIs than TCAs even after controlling for psychiatric factors (univariate analysis P =0.03). 32 Eighty-five patients were on SSRIs (mostly citalopram). Most patients were started on low doses of 5–10 mg, which were titrated up to 60–200 mg depending on the specific SSRI.…”

Section: Ssrismentioning

confidence: 99%

Focus on the use of antidepressants to treat pediatric functional abdominal pain: current perspectives

Bonilla¹,

Nurko²

2018

CEG

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Chronic abdominal pain is frequently encountered in pediatric practice. A large proportion of cases meet Rome criteria for abdominal pain-functional gastrointestinal disorders (AP-FGIDs). These disorders are costly and, in some cases, lead to impairment of daily functioning and overall quality of life. Pathophysiologic mechanisms include early stressful events, visceral hypersensitivity, dysmotility, changes in intestinal microbiota, and altered central nervous system processing. They are considered disorders of the brain–gut interaction. The diagnosis is made on clinical grounds using symptom-based criteria (Rome criteria). Anxiety and depressive symptoms are more prevalent in patients with AP-FGIDs. Therefore, attention has been directed to the use of neuromodulators as potential interventions for AP-FGIDs. Antidepressants are one type of neuromodulators, and one of the most studied drugs for the management of AP-FGIDs in adult and pediatric population. Data available in pediatric population have significant limitations including nonuniform methodology with different study designs and primary endpoints. Evidence of the efficacy of antidepressants in the management of pediatric AP-FGIDs is not consistent. There is an urgent need for well-designed randomized clinical trials using age-appropriate validated outcome measures. Careful consideration must be given to adverse effects, particularly increased suicidal ideation.

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“…Apart from conventional analgesics, some studies have emphasized the antinociceptive effects of antidepressants, such as imipramine. In addition, antidepressants are clinically used to control and treat different types of pain, especially neuropathic pain (10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

The antinociceptive effects of folic acid using formalin and acetic acid tests in male mice

Hajiallilo

Maleki

2021

J Shahrekord Univ Med Sci

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Background and aims: Antidepressant agents such as imipramine are clinically used to control and treat different types of pain, especially neuropathic pain. Studies have shown the antidepressant-like activity of folic acid (FA). This study aimed to investigate the potential antinociceptive effects of FA using formalin and acetic acid tests in male mice. Methods: Sixty male albino mice (20-30 g) were randomly divided into 10 groups (n=6 in each group) of negative control, positive control (morphine or indomethacin), and FA (10, 15, and 30 mg/kg) groups. In the formalin test, duration of paw licking and biting the right hind paw during acute (0-5 minutes) and chronic (15-60 minutes) pain after intraplantar injection of formalin 2.5% (25 µL) was recorded. In the writhing test, the abdominal constrictions were recorded after the intraperitoneal injection of acetic acid 1%. Results: Only a high dose (30 mg/kg) of FA significantly reduced acute pain (P=0.001) compared with the control group. But all doses of FA significantly decreased chronic pain (P=0.001). In addition, morphine significantly reduced both phases of pain (P=0.020 and P=0.001, respectively). Moreover, indomethacin and all doses of FA decreased the number of abdominal constrictions induced by acetic acid (P=0.001). Conclusion: Compared with acute (neurogenic) pain, FA more potently decreases chronic (inflammatory) pain. Furthermore, FA decreases the parietal pain that could potentially represent antinociceptive effect. However, further studies are needed to elucidate the exact mechanism of FA’s analgesic activity.

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Treatment of Functional Abdominal Pain With Antidepressants

Abstract: Patients had significantly greater response to SSRIs than TCAs, remaining significant after controlling for psychiatric factors. Little significance is given to patient's associated gastrointestinal symptoms, frequently resulting in adverse effects and termination of medication.

Cited by 20 publications

References 34 publications

Gastrointestinal Tract Disorders in Older Age

Gastrointestinal Tract Disorders in Older Age

Focus on the use of antidepressants to treat pediatric functional abdominal pain: current perspectives

The antinociceptive effects of folic acid using formalin and acetic acid tests in male mice

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