ISSN: 2008-2258
Vol 16, No 1 (2023): Winter
Comparison the potency of Nortriptyline and Mirtazapine on gastrointestinal symptoms, the level of anxiety and depression in patients with functional dyspepsia Comparison the Impact of Nortriptyline and Mirtazapine on Functional Dyspepsia
Gastroenterology and Hepatology from Bed to Bench,
,
https://doi.org/10.22037/ghfbb.v16i1.2513
Abstract
Background: Functional dyspepsia usually accompanies other psychosocial disorders. According to previous studies, among these disorders, anxiety, and depression have the most correlation. In the current clinical trial study, we compared the potency of mirtazapine and nortriptyline in FD-patients who presented anxiety or depression.
Study design: This randomized clinical trial has been organized in Taleghani hospital (Tehran, Iran). In two parallel groups, 42 patients (22 patients in Mirtazapine 7.5 mg/daily arm and 20 in the Nortriptyline 25 mg/day group) were treated for 12 weeks. The patients with Positive history of antidepressant therapy, organic diseases, alcohol abuse, pregnancy, major psychiatric disorders were excluded. They were examined by three types of questionnaires (Nepean questionnaire, Hamilton questionnaires) three times: 1) before the onset of treatment, 2) during the treatment, and 3) at the end.
Results: Based on Gastrointestinal (GI) manifestation, Mirtazapine in comparison to Nortriptyline could significantly suppress the signs and symptoms, including epigastric pain (P=0.02), belching (P=0.004), and bloating (P=0.01). Although The results revealed that the Mirtazapine with the lower mean depression score of the Hamilton questionnaire at the end of the treatment led to a better result compared to Nortriptyline (P=0.002), but, there are no significant differences between the effects of these drugs on the anxiety scale of patients (P = 0.091).
Conclusion: Mirtazapine is more effective for GI symptoms related to gastric emptying. Whereas, Mirtazapine revealed better outcomes in FD-patients with depression, but according to the level of anxiety, Mirtazapine showed no better outcome in comparison with Nortriptyline.
- Functional Dyspepsia (FD)
- Depression
- Anxiety
- Nortriptyline
- Mirtazapine
How to Cite
References
2. Seyedmirzaei SM, Haghdoost AA, Afshari M, Dehghani A. Prevalence of dyspepsia and its associated factors among the adult population in southeast of iran in 2010. Iranian Red Crescent Medical Journal 2014;16.
3. Kindt S, Van Oudenhove L, Mispelon L, Caenepeel P, Arts J, Tack J. Longitudinal and cross-sectional factors associated with long-term clinical course in functional dyspepsia: a 5-year follow-up study. American Journal of Gastroenterology 2011;106:340-348.
4. Adibi P, Keshteli AH, Daghaghzadeh H, Roohafza H, Pournaghshband N, Afshar H. Association of anxiety, depression, and psychological distress in people with and without functional dyspepsia. Advanced biomedical research 2016;5.
5. Filipović BF, Randjelovic T, Ille T, et al. Anxiety, personality traits and quality of life in functional dyspepsia‐suffering patients. European Journal of Internal Medicine 2013;24:83-86.
6. Chen SL. A review of drug therapy for functional dyspepsia. Journal of digestive diseases 2013;14:623-625.
7. Grover M, Camilleri M. Effects on gastrointestinal functions and symptoms of serotonergic psychoactive agents used in functional gastrointestinal diseases. Journal of gastroenterology 2013;48:177-181.
8. Ford AC, Luthra P, Tack J, Boeckxstaens GE, Moayyedi P, Talley NJ. Efficacy of psychotropic drugs in functional dyspepsia: systematic review and meta-analysis. Gut 2017;66:411-420.
9. Thompson E. Hamilton rating scale for anxiety (HAM-A). Occupational Medicine 2015;65:601.
10. Hantoro IF, Syam AF, Mudjaddid E, Setiati S, Abdullah M. Factors associated with health-related quality of life in patients with functional dyspepsia. Health and quality of life outcomes 2018;16:83.
11. Tomita T, Oshima T, Miwa H. New approaches to diagnosis and treatment of functional dyspepsia. Current gastroenterology reports 2018;20:55.
12. Aro P, Talley NJ, Ronkainen J, et al. Anxiety is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study. Gastroenterology 2009;137:94-100.
13. Talley NJ. Functional dyspepsia: new insights into pathogenesis and therapy. The Korean journal of internal medicine 2016;31:444.
14. Cheong PK, Ford AC, Cheung CK, et al. Low-dose imipramine for refractory functional dyspepsia: a randomised, double-blind, placebo-controlled trial. The Lancet Gastroenterology & Hepatology 2018;3:837-844.
15. Herrick LM, Camilleri M, Schleck CD, Zinsmeister AR, Saito YA, Talley NJ. Effects of amitriptyline and escitalopram on sleep and mood in patients with functional dyspepsia. Clinical Gastroenterology and Hepatology 2018;16:401-406. e402.
16. Talley NJ, Locke GR, Saito YA, et al. Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study. Gastroenterology 2015;149:340-349.e342.
17. Kaosombatwattana U, Pongprasobchai S, Limsrivilai J, Maneerattanaporn M, Leelakusolvong S, Tanwandee T. Efficacy and safety of nortriptyline in functional dyspepsia in Asians: A randomized double-blind placebo-controlled trial. J Gastroenterol Hepatol 2018;33:411-417.
18. Törnblom H, Drossman DA. Psychotropics, Antidepressants, and Visceral Analgesics in Functional Gastrointestinal Disorders. Curr Gastroenterol Rep 2018;20:58.
19. Carbone F, Vanuytsel T, Tack J. The effect of mirtazapine on gastric accommodation, gastric sensitivity to distention, and nutrient tolerance in healthy subjects. Neurogastroenterol Motil 2017;29.
20. Tack J, Janssen P. Emerging drugs for functional dyspepsia. Expert Opin Emerg Drugs 2011;16:283-292.
21. Tack J, Ly HG, Carbone F, et al. Efficacy of Mirtazapine in Patients With Functional Dyspepsia and Weight Loss. Clin Gastroenterol Hepatol 2016;14:385-392.e384.
22. Luo L, Du L, Shen J, Cen M, Dai N. Benefit of small dose antidepressants for functional dyspepsia: Experience from a tertiary center in eastern China. Medicine (Baltimore) 2019;98:e17501.
23. Choung RS, Cremonini F, Thapa P, Zinsmeister AR, Talley NJ. The effect of short-term, low-dose tricyclic and tetracyclic antidepressant treatment on satiation, postnutrient load gastrointestinal symptoms and gastric emptying: a double-blind, randomized, placebo-controlled trial. Neurogastroenterol Motil 2008;20:220-227.
- Abstract Viewed: 0 times
