The effects of antidepressants on gastric ulcer

Yıl 2013, Cilt: 40 Sayı: 4, 691 - 699, 01.12.2013

Mehmet Latif Güneş Esra Yazıcı Ahmet Bülent Yazıcı İrmak Ferah Elif Çadırcı

https://doi.org/10.5798/diclemedj.0921.2013.04.0362

Cited By: 1

Öz

In their daily practice, psychiatrists often experience gastric complaints in patients beside psychiatric disorders. Peptic ulcer is one of the diseases, which accompany to psychiatric disorders including mainly depression. It is shown that antidepressants can inflame the bleedings including gastrointestinal (GI) bleedings, while they have positive effect on ulcer healing. In this review, studies, which conducted about the positive or negative effects of antidepressant drugs on ulcer treatment were examined. Accordingly; it was found that opipramol, amitriptyline, imipramine that of tricyclic antidepressants was found to be helpful in healing of the ulcer. It was stated that Selective Serotonin Reuptake Inhibitors generally inflamed ulcers, exceptionally fluvoxamine and fluoxetine reduced ulcer; moclobemide that of monoamine-oxidase inhibitor and tianeptine and mirtazapine that of atypical antidepressants had positive effect in ulcer healing. To be careful in choosing the appropriate antidepressant in psychiatric patients with gastric ulcer is important in the prognosis of both ulcer and depression.

Anahtar Kelimeler

peptic ulcer; depression; antidepressant drugs

Antidepresan ilaçların gastrik ülser üzerine etkileri

Öz

Psikiyatri hekimleri günlük uygulamalarında hastalarının psikiyatrik bozuklarının yanında sık sık mide ile ilgili şikayetleri ile karşılaşırlar. Ülser başta depresyon olmak üzere psikiyatrik hastalıklara eşlik eden hastalıklardan biridir. Antidepresanların bir yandan gastrointestinal (GI) kanamaları da dahil olmak üzere kanamaları alevlendirebildiği diğer yandan ise ülser iyileşmesine yardımcı etkisinin olabildiği gösterilmiştir. Bu derlemede antidepresan ilaçların ülser tedavisi üzerindeki olumlu ya da olumsuz etkileri hakkında yapılan çalışmalar incelenmiştir. Buna göre trisiklik antidepresanlardan opipramol, amitriptilin, imipraminin ülserin iyileşmesine yardımcı olduğu anlaşılmıştır. Selektif Serotonin Gerialim İnhibitörleri grubu ilaçların genel olarak ülseri alevlendirdiği, fluvoksaminin ve fluoksetinin istisnai olarak ülseri azalttığı, Monoamin oksidaz inhibitörlerinden olan moklobemidin ve atipik antidepresanlar olan tianeptin ve mirtazapinin ülserin iyileşmesine yardımcı etkileri olduğu belirtilmiştir. Ülseri olan psikiyatri hastalarına uygun antidepresan seçiminde dikkatli olmak hem ülserin hem de depresyonun seyri açısından önemlidir.

Anahtar Kelimeler

Peptik ülser, depresyon, antidepresan ilaçlar

Kaynakça

• Zhang S, Xu Z, Gao Y, et al. Bidirectional crosstalk between stress-induced gastric ulcer and depression under chronic stress. PloS One 2012;7:e51148.
• Chrousos GP, Loriaux DL, Gold PW. Mechanisms of Physi- cal and Emotional Stress. Advances in Experimental Medi- cine and Biology. 245. New York: Plenum Press; 1988.
• Chrousos GP. Basic Mechanisms and Clinical Implications (Annals of the New York Academy of Sciences). 771. New York: New York Academy of Sciences; 1996.
• Sarıyıldız MA, Batmaz İ, Budulgan M, et al. Depressive symptoms in patients with systemic sclerosis: Association between clinical variables, functional status and the quality of life. Dicle Medical Journal 2013;40:62-67.
• Hano J, Bugajski J, Wantuch C. The effect of drugs interfer- ing with biogenic amines metabolism on gastric secretion and reserpine-ulcers development in rats. Pol J Pharmacol Pharm 1978;30:501-511.
• Nobrega JN, Wiener NI. Effects of catecholamine agonist and antagonist drugs on acute stomach ulceration induced by medial hypothalamic lesions in rats. Pharmacol Bio- chem Behav 1983;19:831-838.
• Pare W, Redei E. Depressive behavior and stress ulcer in Wi- star Kyoto rats. J Physiol Paris 1993;87:229-238.
• Fernandez de la Gandara F, Casas Carnicero J, Velasco Mar- tin A. Effects of antidepressants on alcohol-induced gastric mucosal injury in rats. Methods Find Exp Clin Pharmacol 1989;11:635-639.
• Gabry K, Chrousos G, Rice K. Marked suppression of gastric ulcerogenesis and intestinal responses to stress by a novel class of drugs. Mol Psychiatry 2002;7:474-483.
• Keshavarzian A, Wibowo A, Gordon JH, Fields JZ. MPTP- induced duodenal ulcers in rat. Prevention by reuptake blockers for serotonin and norepinephrine, but not dopa- mine. Gastroenterology 1990;98:554-560.
• Sen T, Abdulsalam C, Pal S, et al. Effect of amitriptyline on gastric ulceration. Fundam Clin Pharmacol 2002; 16:311- 315.
• Utkan T, Ulak G, Yildiran H, et al. Investigation on the mechanism involved in the effects of agmatine on eth- anol-induced gastric mucosal injury in rats. Life Sci 2000;66:1705-1711.
• Andersen O, Bergsaker-Aspoy J, Halvorsen L, Giercksky K. Doxepin in the treatment of duodenal ulcer. A double- blind clinical study comparing doxepin and placebo. Scand J Gastroenterol 1984;19:923-925.
• Shrivastava R, Siegal H, Lawlor R, et al. Doxepin therapy for duodenal ulcer: a controlled trial in patients who failed to respond to cimetidine. Clin Ther 1985;7:319-326.
• Ashley S, Evoy D, Daly J. Stomach. In: Schwartz SI, Shires TG, Spencer FC, editors. Principles of Surgery Seventh Edition. New York: McGraw-Hill;1999; 933-997.
• Silen W, Merhav A, Simson N. The pathophysiology of stress ulcer disease. World J Surg 1981;5:165-174.
• Doğan E, Kefeli A, Nazlıgül Y, et al. Helicobakter pilori ile enfekte duodenal ülser ve fonksiyonel dispepsi hastalarında anti-CagA pozitifliği ve eradikasyon tedavi başarısına etki- si. Dicle Tıp Dergisi 2011;38:7-11.
• Vale DJ. Peptic ulcer disease and related disorders. In: Braunwald E, Hauser SL, Faucci AS, editors. Harrison’s 15 th edition Principles of Internal Medicine. New York: McGraw-Hill; 2001.
• Doğan E, Kefeli A, Nazlıgül Y, et al. Anti-CagA positivity in duodenal ulcer and functional dyspepsia patients infected with Helicobacter pylori and its effect on the outcome of eradication treatment. Dicle Medical Journal. 2011; 38:7- 11.
• Gönen Ö, Dicle O, İlter T. Gastrointestinal Sistem Hastalıkları. In: İliçin G, Ünal S, Biberoğlu K, editors. Temel İç Hastalıkları. Ankara: Güneş Kitabevi; 1996;923- 1066.
• Pappas T. The stomach and duodenum. In: Sabiston D, Lyerly H, editors. Textbook Of Surgery. New York: WB Sounders. 1999;847-860.
• Jiang P, Chang L, Tang S, et al. Protective role of metallo- thionein in stress-induced gastric ulcer in rats. World J Gas- troenterol 2005;11:2739-2743.
• Magni G, Salmi A, Paterlini A, et al. Psychological distress in duodenal ulcer and acut gastroduodenitis, A controlled study. Dig Dis Sci 1982; 27:1081-1084.
• Kayaalp OS. Peptik Ülser Tedavisinde Kullanılan İlaçlar. In: Ozdemir O, Topal G, Yıldırım A, Kayaalp O, editors. Akılcıl Tedavi Yönünden Tıbbi Farmakoloji. 13 ed. Anka- ra: Pelikan Kitabevi; 2012;1409-1422.
• Örsel S. Depresyonda Tedavi: Genel Ilkeler ve Kullanilan Antidepresan Ilaçlar Klinik Psikiyatri 2004;4:17-24.
• Albayrak A. Moklobemidin sıçanlarda antiülser ve antiok- sidan aktivitesinin araştırılması. Erzurum: Atatürk Üniver- sitesi; 2008.
• Dalgic H, Papak O. Trisiklik Antidepresanların Analjezik/ Antinosiseptif Etki MEkanizmaları. Erciyes Tıp Dergisi (Erciyes Medical Journal) 2003;25:98-103.
• Kerr GW, McGuffie AC, Wilkie S. Tricyclic antidepressant overdose: a review. Emergency medicine journal : EMJ. 2001;18:236-241.
• Guldahl M. The effect of trimipramine (Surmontil) in masked depression in patients with duodenal ulcer. A dou- ble blind study. Scan J Gastroentrol 1975;43:27-31.
• Olden KW. The use of antidepressants in functional gastro- intestinal disorders: new uses for old drugs. CNS spectrums 2005;10:891-896.
• Aguwa C, Ramanujam T. Antiulcer effects of trimipra- mine using various laboratory models. Jap J Pharmacol 1984;36:125-129.
• Haga K, Osuga K, Nakanishi A, Tsumagari T. Antiulcer ac- tivity of clotiazepam in rats. Jpn J Pharmacol 1984;34:381- 387.
• Synder SH, Yamamura H. Antidepressants and the mus- carinic acetylcholine receptor. Arch Gen Psychiatr 1977;34:236-239.
• Rainsford KD. Inhibition by leukotriene inhibitors, and calcium and platelet-activating factor antagonists, of acute gastric and intestinal damage in arthritic rats and in choli- nomimetic- treated mice. JPharm Pharmacol 1999;51:331- 333.
• Neilson ST, Beninati L, Chang J. REV 5901 and Ly 171,883 protect rat gastric mucosa against ethanol-induced damage. Agents Actions 1987;21:320-322.
• Ogle C, Cho C. The protective mechanism of FPL 55712 against stress-induced gastric ulceration in rats. Agents Ac- tions 1987;26:350-354.
• Parmar NS, Tariq M, Ageel AM. Gastric cytoprotection: a critical appraisal of the concept, methodology, implica- tion, mechanisms and future research. Agents Actions 1987;22:114-121.
• Bickel M. Antiulcer effects of nomifensine, a new antide- pressant, on stress-induced ulcers in the rat. Arzneimittel- Forschung. 1980; 30:69-73.
• Alanko JR, Riutta A, Vapataalo H. Effects of catecholamines on eicosanoid synthesis with special reference to prostanoid ⁄ leukotriene ratio. Free Rad Biol Med. 1992;13:677-688.
• Hernandez DE, Xue BG. Imipramine prevents stress gastric glandular lesions in rats. Neurosci Lett. 1989; 103:209-212.
• Hernandez DE, Arredondo ME, Xue BG. Imipramine pre- vents gastric lesions induced by centrally administered thyrotropin-releasing hormone (TRH) in rats. Neurosci Lett 1990;111:339-343.
• Dursun H, Albayrak F, Bilici M, et al. Gastroprotective and antioxidant effects of opipramol on indomethacin-induced ulcers in rats. Yakugaku Zasshi 2009;129:861-869.
• Ruud T, Hoff G, Tonder M, Holter O. Doxepin and cimeti- dine in the treatment of duodenal ulcer: an open clinical and endoscopic study. J Clin Psychiatry 1982;43:56-60.
• Andrade C, Sandarsh S, Chethan KB, Nagesh KS. Serotonin reuptake inhibitor antidepressants and abnormal bleeding: a review for clinicians and a reconsideration of mechanisms. J Clin Psychiatry 2010;71:1565-1575.
• Spina E, Santoro V, D’Arrigo C. Clinically relevant phar- macokinetic drug interactions with second-generation anti- depressants: an update. Clin Ther. 2008; 30:1206-1227.
• Schlezinger JJ, White RD, Stegeman JJ. Oxidative inac- tivation of cytochrome P-450 1A (CYP1A) stimulated by 3,3’,4,4’-tetrachlorobiphenyl: production of reactive oxy- gen by vertebrate CYP1As. Mol Pharmacol 1999;56:588- 597.
• Itoh M, Guth PH. Role of oxygen-derived free radicals in hemorrhagic shock-induced gastric lesions in the rat. Gas- troenterology 1985;88:1162-1167.
• Jainu M, Devi CS. Gastroprotective action of Cissus quad- rangularis extract against NSAID induced gastric ulcer: role of proinflammatory cytokines and oxidative damage. Chem Biol Interact 2006;10:262-270.
• Bayir Y, Odabasoglu F, Cakir A, et al. The inhibition of gastric mucosal lesion, oxidative stress and neutrophil-in- filtration in rats by the lichen constituent diffractaic acid. Phytomedicine 2006;13:584-590.
• Lewis JD, Strom BL, Localio AR, et al. Moderate and high affinity serotonin reuptake inhibitors increase the risk of upper gastrointestinal toxicity. Pharmacoepidemiol Drug Saf 2008;17:328-335.
• Ma J VR, Boddam R, Auger S, Sampalis J. Association between antidepressant use and prescribing of gastric acid suppressants. Can J Psychiatry 2006; 51:178-184.
• Yamaguchi T, Hidaka N, Suemaru K, Araki H. The coad- ministration of paroxetine and low-dose aspirin synergisti- cally enhances gastric ulcerogenic risk in rats. Biol Pharm Bull 2008;31:1371-1375.
• Dursun H, Bilici M, Albayrak F, et al. Antiulcer activity of fluvoxamine in rats and its effect on oxidant and antioxi- dant parameters in stomach tissue. BMC Gastroenterology 2009;9:36.
• Ji CX, Fan DS, Li W, et al. Evaluation of the anti-ulcerogen- ic activity of the antidepressants duloxetine, amitriptyline, fluoxetine and mirtazapine in different models of experi- mental gastric ulcer in rats. Eur J Pharmacol 2012;691:46- 51.
• Abdel-Sater KA, Abdel-Daiem WM, Sayyed Bakheet M. The gender difference of selective serotonin reuptake in- hibitor, fluoxetine in adult rats with stress-induced gastric ulcer. Eur J Pharmacol 2012;688:42-48.
• Takahashi T, Suzuki G, Nibuya M, et al. Therapeutic ef- fect of paroxetine on stress-induced gastric lesions in mice. Prog Neuropsychopharmacol Biol Psychiatry 2012; 36:39- 43.
• Wilson JA, Read JR, Boyd EJ, Wormsley KG. Inhibition of pentagastrin-stimulated and overnight gastric secretion by mianserin. Br J Clin Pharmacol 1983;15:329-333.
• Frazer A. Antidepressant drugs. Depression 1994;2:1-19.
• Rudorfer MV, Manji HK, Potter WZ. Comparative toler- ability profiles of the newer versus older antidepressants. Drug Saf 1994;10:18-46.
• de Jong JC, van den Berg PB, Tobi H, de Jong-van den Berg LT. Combined use of SSRIs and NSAIDs increases the risk of gastrointestinal adverse effects. Br J Clin Pharmacol 2003;55:591-595.
• Ferguson JM. SSRI Antidepressant Medications: Adverse Effects and Tolerability. Prim Care Companion J Clin Psy- chiatry 2001;3:22-27.
• de Boer T. The effects of mirtazapine on central noradren- ergic and serotonergic neurotransmission. Int Clin Psycho- pharmacol 1995;10:19-23.
• Bilici M, Ozturk C, Dursun H, et al. Protective effect of mirtazapine on indomethacin-induced ulcer in rats and its relationship with oxidant and antioxidant parameters. Dig Dis Sci 2009;54:1868-1875.
• Dubovsky SL. Beyond the serotonin reuptakeinhibitors: ra- tionales for the development of new serotonergic agents. J Clin Psychiatry 1994;55:34-44.
• Agargun MY, Ebrinc S. Mirtazapin: Bir gözden gecirme. Klinik Psikofarmakoloji Bulteni 1998;8:59-68.
• Naito Y, Yoshikawa T, Yoshida N, Kondo M. Role of oxy- gen radical and lipid peroxidation in indomethacin-induced gastric mucosal injury. Dig Dis Sci 1998;43:30-34.
• Hirota M, Inoue M, Ando Y, et al. Inhibition of stress-in- duced gastric injury in the rat by glutathione. Gastroenter- ology 1989;97:853-859.
• Robert A, Eberle D, Kaplowitz N. Role of glutathione in gas- tric mucosal cytoprotection. Am J Physiol 1984;247:296- 304.
• Talas DU, Nayci A, Polat G, et al. The effects of dexametha- sone on lipid peroxidation and nitric oxide levels on the healing of tracheal anastomoses: an experimental study in rats. Pharmacol Res 2002;46:265-271.
• Demircan B, Celik G, Suleyman H, Akcay F. Effect of indo- methacin, celecoxib and meloxicam on glutathione; malo- ndialdehyde and myeloperoxidase in rat gastric tissue. Pain Clin Ther 2005;17:25-31..
• Charoenphandhu N, Teerapornpuntakit J, Lapmanee S, et al. Duodenal calcium transporter mRNA expression in stressed male rats treated with diazepam, fluoxetine, rebox- etine, or venlafaxine. Mol Cell Biochem. 2012; 369:87-94.
• Hallback I, Hagg S, Eriksson AC, Whiss PA. In vitro ef- fects of serotonin and noradrenaline reuptake inhibitors on human platelet adhesion and coagulation. Pharmacol Rep 2012;64:979-983.
• Glavin GB, Dugani AM. Effects of dopamine agonists and antagonists on gastric acid secretion and stress responses in rats. Life Sci 1987;41:1397-1408.
• Suleyman H, Cadirci E, Albayrak A, et al. Comparative study on the gastroprotective potential of some antidepres- sants in indomethacin-induced ulcer in rats. Chem Biol In- teract 2009;180:318-324.
• Takeuchi K, Tanaka A, Nukui K, et al. Aggravation by par- oxetine, a selective serotonin reuptake inhibitor, of antral lesions generated by nonsteroidal anti-inflammatory drugs in rats. J Pharmacol Exp Therapeutics 2011; 338:850-859.
• Suleyman H, Akcay F, Altinkaynak K. The effect of nime- sulide on the indomethacin- and ethanol-induced gastric ulcer in rats. Pharmacol Res 2002;45:155-158.