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Bir Prospektif Çalışma: İrritabl Barsak Sendromu\'nda Sitalopram Kullanımı

Year 2014, Volume: 11 Issue: 2, 123 - 129, 01.08.2014

Abstract

Amaç: İrritabl Barsak Sendromu İBS yaygın görülen bir durumdur. Medikal tedavisinde antidepresanlar ve antispazmotikler kullanılır. Çalışmamızda, selektif serotonin reuptake inhibitörü SSRI grubundan bir antidepresan olan sitalopramın, İBS semptomları ve depresyon- anksiyete skorları üzerine etkisini araştırmayı amaçladık.Materyal ve Metot: Çalışmaya, Roma 3 tanı kriterlerine göre İBS tanısı konan 103 hasta alındı. İBS'li hastalar, 3 gruba bölündü: 1. grupta n=29 Beck Depresyon Skoru BDS ve Beck Anksiyete Skoru BAS minimal- hafif derecede olan hastalara, bir antispazmotik olan otilonyum bromide 120 mg/gün verildi. 2. grupta n=41 BDS ve BAS orta- ciddi olanlara, otilonyum bromid 120 mg/gün ve sitalopram 20 mg/gün verildi. 3. grupta n=33 ise yine BDS ve BAS orta- ciddi olanlara, sadece otilonyum bromid 120 mg/gün verildi. 3 aylık tedavinin sonunda, tedavi cevapları İBS şiddeti skorlama sistemi ve BDS- BAS ile değerlendirildi. Bulgular: Tedavi sonunda 1. ve 2. gruplarda BDS ve BAS'larda anlamlı düzelmeler olurken p0,05 . İBS şiddet skorlarında ise, 1. grupta daha belirgin olmak üzere, her üç grupta da istatistiksel olarak anlamlı azalmalar oldu p0,05 .Sonuç: Bulgularımıza göre, İBS'li hastalardaki depresyon ve anksiyete şiddetli değilse, bu hastaların tedavisinde tek başına antipazmotik verilmesi, uygun bir seçenek olabilir

References

  • ) Wells NE, Hahn BA, Whorwell PJ. Clinical economics review: irritable bowel syndrome. Aliment Pharmacol Ther. 1997;11(2):1019-30.
  • ) Garakani A, Win T, Virk S, Gupta S, Kaplan D, Masand PS. Comorbidity of irritable bowel syndrome in psychiatric patients: a review. Am J Ther. ;10(3):61-7. ) Talley NJ. Irritable Bowel Syndrome. Intern Med J. ;36(1):724-8. ) Musial F, Hauser W, Langhorst J, Dobos G, Enck P. Psychophysiology of visceral pain in IBS and health. J Psychosom Res. 2008;64(3):589-97.
  • ) Colucci R, Blandizzi C, Bellini M, Ghisu N, Tonini M, Del TM. The genetics of the serotonin transporter and irritable bowel syndrome. Trends Mol Med. ;14(4):295-304. ) Crowell MD. Role of serotonin in the pathophysiology of the irritable bowel syndrome. Br J Pharmacol. 2004;141(6):1285-93.
  • ) Creed F, Guthrie E. Psychological factors in the irritable bowel syndrome. Gut. 1987;28(2):1307-18.
  • ) Lydiard B. Irritable bowel syndrome, anxiety, and depression: what are the links? J Clin Psychiatry. ;62(1):38-45. ) Mertz H. Role of the brain and sensory pathways in gastrointestinal sensory disorders in humans. Gut. ;51(3):29-33. ) Frederic RC. Irritable Bowel Syndrome and Antidepressants. J Manag Care Pharm.2008;14(4):882
  • ) Garvin B, Wiley JW. The role of serotonin in irritable bowel syndrome: implications for management. Curr Gastroenterol Rep.2008;10(3):363-8.
  • ) Hayee B, Forgacs I. Psychological approach to m a n a g i n g i r r i t a b l e b o w e l s y n d r o m e . BMJ.2007;334(5):1105-9.
  • ) Bahar RJ, Collins BS, Steinmetz B, Ament ME. Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents. J Pediatr. 2008; 152(2):685-9.
  • ) Trinkley KE, Nahata MC. Treatment of irritable bowel syndrome. J Clin Pharm Ther. 2011;36(4):275-82.
  • ) Quartero A, Meineche SV, Muris JW, Rubin G, de Wit N. Bulking agents, antispasmodic and antidepressant medication for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2011. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.C D003460.pub3/abstract
  • Drossman DA, Corrazziari E, Delvaux M, Spiller R, Talley NJ, Thompson WG, et al. Guidelines - Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders. J Gastrointestin Liver Dis. 2006;15(5):307
  • ) Beck AT. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(1):561-71.
  • ) Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(2):893-7.
  • ) Hisli N. Reability and validity of Beck Depression Inventory among university students. Turk J Psychol. ;7(1):3-13. ) Ulusoy M, Erkmen H, Sahin N. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother. 1998;12(2):163-72.
  • ) Kilinc S, Torun F. Depression Rating Scales Used in Clinical Practice in Turkey. Dirim Medical Journal ;1(3):139-49. ) Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11(2):395-402.
  • ) Jackson JL, O'Malley PG, Tomkins G, Balden E, Santoro J, Kroenke K. Treatment of functional gastrointestinal disorders with antidepressant m e d i c a t i o n s : a m e t a - a n a l y s i s . A m J Med.2000;108(4):65-72.
  • ) Farthing MJ. Treatment of irritable bowel syndrome. BMJ.2005;330(5):429-30.
  • ) Baldessarini RJ. Drug therapy of depression and anxiety disorders. Goodman & Gilman's The Pharmacologic Basis of Therapeutics. 2010;28(6):221-6.
  • ) Charles DG, Mary JG, Richard AA, Abhijit C, Christine D, Pierre P, et al. Irritable bowel syndrome: an international study of symptoms in eight countries. Eur J Gastroenterol Hepatol. 2008;20(4):659-67.
  • ) Megan F, Sarah EG, Geoffrey CW. Effects of Antidepressants in Patients With Irritable Bowel Syndrome and Comorbid Depression. Clin Ther. ;32(3):1221-33.
  • ) Ladabaum U, Sharabidze A, Levin TR, Zhao WK, Chung E, Bacchetti P, et al. Citalopram provides little or no benefit in nondepressed patients with irritable bowel sydrome. Clin Gastroenterol Hepatol. 2010;8(1):42-8.
  • ) Tack j, Broekaert d, Fischler b, Oudenhove lv, Gevers am, Janssens j. A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome. Gut. 2006;55(2):1095-103.
  • ) Lesbros PD, Michetti P, Fried M, Beglinger C, Blum AL. Meta-analysis: the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2004;20(2):1253-69.
  • ) Fock KM, Chew CN, Tay LK, Peh LH, Chan S, Pang EPH. Psychiatric illness, personality traits and the irritable bowel syndrome. Ann Acad Med Singapore. ;30(5):611-4.

The use of citalopram in Irritable Bowel Syndrome: A prospective study

Year 2014, Volume: 11 Issue: 2, 123 - 129, 01.08.2014

Abstract

Background: Irritable Bowel Syndrome IBS is a commonly seen condition. Medications used in its treatment include anti-depressants and anti-spasmotics. This study aimed to examine the effect of citalopram, a selective serotonin reuptake inhibitor groupped antidepressant on IBS symptoms and depression-anxiety scores.Materaial and Methods: 103 patients diagnosed with IBS according to the Rome 3 diagnostic criteria were included in the study. Patientswith IBS were divided into three groups:those with minimal-mild Beck Depression Score BDS and Beck Anxiety Score BAS were only given otilonium bromide 120 mg/day group 1, n=29 , those with moderate- severe scores were given otilonium bromide120 mg/day and citalopram20 mg/day group 2, n=41 and those with moderate- severe scores were only given otilonium bromide 120 mg/day group 3, n=33 . At the end of 3 months treatment, the responses to treatment were evaluated with the IBS severity scoring system and BDS-BAS.Results: While a significant improvement was detected in the BDS and BAS of first and second groups . p0,05 .Statistically significant improvementwas found in IBS severity score of three groups p0,05 .Conclusion: According to our findings, if depression and anxiety in IBS patients are not so severe, a treatment regime with only anti-spasmotics may be an appropriate choice

References

  • ) Wells NE, Hahn BA, Whorwell PJ. Clinical economics review: irritable bowel syndrome. Aliment Pharmacol Ther. 1997;11(2):1019-30.
  • ) Garakani A, Win T, Virk S, Gupta S, Kaplan D, Masand PS. Comorbidity of irritable bowel syndrome in psychiatric patients: a review. Am J Ther. ;10(3):61-7. ) Talley NJ. Irritable Bowel Syndrome. Intern Med J. ;36(1):724-8. ) Musial F, Hauser W, Langhorst J, Dobos G, Enck P. Psychophysiology of visceral pain in IBS and health. J Psychosom Res. 2008;64(3):589-97.
  • ) Colucci R, Blandizzi C, Bellini M, Ghisu N, Tonini M, Del TM. The genetics of the serotonin transporter and irritable bowel syndrome. Trends Mol Med. ;14(4):295-304. ) Crowell MD. Role of serotonin in the pathophysiology of the irritable bowel syndrome. Br J Pharmacol. 2004;141(6):1285-93.
  • ) Creed F, Guthrie E. Psychological factors in the irritable bowel syndrome. Gut. 1987;28(2):1307-18.
  • ) Lydiard B. Irritable bowel syndrome, anxiety, and depression: what are the links? J Clin Psychiatry. ;62(1):38-45. ) Mertz H. Role of the brain and sensory pathways in gastrointestinal sensory disorders in humans. Gut. ;51(3):29-33. ) Frederic RC. Irritable Bowel Syndrome and Antidepressants. J Manag Care Pharm.2008;14(4):882
  • ) Garvin B, Wiley JW. The role of serotonin in irritable bowel syndrome: implications for management. Curr Gastroenterol Rep.2008;10(3):363-8.
  • ) Hayee B, Forgacs I. Psychological approach to m a n a g i n g i r r i t a b l e b o w e l s y n d r o m e . BMJ.2007;334(5):1105-9.
  • ) Bahar RJ, Collins BS, Steinmetz B, Ament ME. Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents. J Pediatr. 2008; 152(2):685-9.
  • ) Trinkley KE, Nahata MC. Treatment of irritable bowel syndrome. J Clin Pharm Ther. 2011;36(4):275-82.
  • ) Quartero A, Meineche SV, Muris JW, Rubin G, de Wit N. Bulking agents, antispasmodic and antidepressant medication for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2011. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.C D003460.pub3/abstract
  • Drossman DA, Corrazziari E, Delvaux M, Spiller R, Talley NJ, Thompson WG, et al. Guidelines - Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders. J Gastrointestin Liver Dis. 2006;15(5):307
  • ) Beck AT. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(1):561-71.
  • ) Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(2):893-7.
  • ) Hisli N. Reability and validity of Beck Depression Inventory among university students. Turk J Psychol. ;7(1):3-13. ) Ulusoy M, Erkmen H, Sahin N. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother. 1998;12(2):163-72.
  • ) Kilinc S, Torun F. Depression Rating Scales Used in Clinical Practice in Turkey. Dirim Medical Journal ;1(3):139-49. ) Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11(2):395-402.
  • ) Jackson JL, O'Malley PG, Tomkins G, Balden E, Santoro J, Kroenke K. Treatment of functional gastrointestinal disorders with antidepressant m e d i c a t i o n s : a m e t a - a n a l y s i s . A m J Med.2000;108(4):65-72.
  • ) Farthing MJ. Treatment of irritable bowel syndrome. BMJ.2005;330(5):429-30.
  • ) Baldessarini RJ. Drug therapy of depression and anxiety disorders. Goodman & Gilman's The Pharmacologic Basis of Therapeutics. 2010;28(6):221-6.
  • ) Charles DG, Mary JG, Richard AA, Abhijit C, Christine D, Pierre P, et al. Irritable bowel syndrome: an international study of symptoms in eight countries. Eur J Gastroenterol Hepatol. 2008;20(4):659-67.
  • ) Megan F, Sarah EG, Geoffrey CW. Effects of Antidepressants in Patients With Irritable Bowel Syndrome and Comorbid Depression. Clin Ther. ;32(3):1221-33.
  • ) Ladabaum U, Sharabidze A, Levin TR, Zhao WK, Chung E, Bacchetti P, et al. Citalopram provides little or no benefit in nondepressed patients with irritable bowel sydrome. Clin Gastroenterol Hepatol. 2010;8(1):42-8.
  • ) Tack j, Broekaert d, Fischler b, Oudenhove lv, Gevers am, Janssens j. A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome. Gut. 2006;55(2):1095-103.
  • ) Lesbros PD, Michetti P, Fried M, Beglinger C, Blum AL. Meta-analysis: the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2004;20(2):1253-69.
  • ) Fock KM, Chew CN, Tay LK, Peh LH, Chan S, Pang EPH. Psychiatric illness, personality traits and the irritable bowel syndrome. Ann Acad Med Singapore. ;30(5):611-4.
There are 24 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Timuçin Aydoğan This is me

Fatih Karababa This is me

Serkan Yalçın This is me

Salih Selek This is me

Turgay Ulaş This is me

İbrahim Arslan This is me

Ahmet Uyanıkoğlu This is me

Haşim Nar This is me

Publication Date August 1, 2014
Published in Issue Year 2014 Volume: 11 Issue: 2

Cite

Vancouver Aydoğan T, Karababa F, Yalçın S, Selek S, Ulaş T, Arslan İ, Uyanıkoğlu A, Nar H. The use of citalopram in Irritable Bowel Syndrome: A prospective study. Harran Üniversitesi Tıp Fakültesi Dergisi. 2014;11(2):123-9.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty