Benefit of small dose antidepressants for functional dyspepsia Experience from a tertiary center in eastern China
Benefit of small dose antidepressants for functional dyspepsia Experience from a tertiary center in eastern China
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DOI：
10.1097/md.0000000000017501
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发表时间：
2019-10-01
期刊：
影响因子：
1.6
通讯作者：
Dai，Ning
中科院分区：
文献类型：
--
作者：
Luo，Liang;Du，Lijun;Dai，Ning
背景：功能性消化不良(FD)的传统治疗在部分FD患者中并不令人满意，抗抑郁药物的潜在作用也没有明确的阐明。为了为未来的最佳实践建议提供更多证据，我们回顾了一年来抗抑郁药物在门诊FD患者中应用的临床数据库。方法：参照功能性胃肠疾病专家诊所对患者的临床表现、疗程和结果进行图表回顾。对130例FD患者进行进一步分析。结果：患者根据不同症状给予不同的抗抑郁药物治疗。最常使用的药物是氟苯硫醇、美力曲辛和氟西汀。好转率93.8%，完全缓解率54.6%。在总体分析中，与舒必利和米氮平相比，西酞普兰有更好的结果的趋势。同时，在餐后窘迫综合征亚组分析中，与任何其他抗抑郁药物方案相比，含有氟西汀的方案显著提高了缓解率。此外，年龄较大的患者更有可能实现缓解。然而，性别和症状持续时间与症状缓解无关。最后，11.5%的患者经历了不良事件。结论：这项回顾性队列研究表明，小剂量抗抑郁药物治疗，特别是西酞普兰和氟西汀，是治疗难治性FD的有效和耐受性良好的治疗方案。
Background:Traditional treatment of functional dyspepsia (FD) is unsatisfactory in a subgroup of patients with FD, and the potential role of antidepressant medications also has not been definitely clarified. To provide more evidence for future optimal practice recommendations, we reviewed a 1-year clinical database of antidepressant agents applied in outpatients with FD.Methods:Clinical presentations, treatment course, and outcomes were determined by chart review of patients referring to the functional gastrointestinal disorders specialist clinic. One hundred thirty patients with FD were included for further analysis.Results:Patients were treated with different antidepressant drugs according to individual symptoms. The most commonly used drugs were flupenthixol melitracen and fluoxetine. Improvement and complete remission occurred in 93.8% and 54.6% of patients, respectively. There was a trend toward superior outcome for citalopram compared to sulpiride and mirtazapine in overall analysis. Meanwhile, regimens containing fluoxetine had significant increased remission rate compared to any other antidepressant regimens in postprandial distress syndrome subgroup analysis. Furthermore, older patients were more likely to achieve remission. However, sex and symptom duration were not associated with symptom remission. Finally, 11.5% of patients experienced adverse events.Conclusions:This retrospective cohort study indicated that small dose antidepressant therapy, especially citalopram and fluoxetine, is an effective and well tolerated treatment option for refractory FD.