短期、低剂量三环和四环抗抑郁药治疗对饱腹感、营养负荷后胃肠道症状及胃排空的影响:一项双盲、随机、安慰剂对照试验。
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.
作者信息
Choung R S, Cremonini F, Thapa P, Zinsmeister A R, Talley N J
机构信息
Mayo Clinic Division of Gastroenterology and Hepatology, and Clinical Enteric Neuroscience, Translational & Epidemiological Research Program (CENTER), Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA.
出版信息
Neurogastroenterol Motil. 2008 Mar;20(3):220-7. doi: 10.1111/j.1365-2982.2007.01029.x. Epub 2007 Nov 20.
Antidepressants are commonly prescribed for patients with functional dyspepsia. However, the effect of tricyclic antidepressants on satiation and gastric emptying remains unclear, and there are no data for tetracyclic compounds. To compare the effects of nortriptyline (maximum dose: 50 mg daily) and mirtazapine (30 mg daily) vs placebo on gastric emptying, gastric satiation and postprandial symptoms after a nutrient load in healthy volunteers. Randomized, double-blind, placebo-controlled study evaluated gastric function before and after 14 days of nortriptyline (n = 13), mirtazapine (n = 13), or placebo (n = 14) in healthy volunteers. Validated methods were used to study gastric emptying ((13)C-octanoate) and satiation postnutrient drink test. The three arms were comparable with regard to age, gender, body mass index and hospital anxiety/depression scale. There were no statistically significant effects of mirtazapine or nortriptyline on gastric emptying compared to placebo (P = 0.34). Maximum tolerated volume was similar on drug and placebo (P = 0.56). Aggregate symptom score 30 min postmaximum tolerated volume after nutrient drink challenge on placebo was 132 (+/-21), vs 165 (+/-21) on mirtazapine, and 126 (+/-21) on nortriptyline 50 mg respectively (P = 0.28). Tricyclic and tetracyclic antidepressant agents do not appear to have significant effects on gastric motor or satiation postnutrient challenge in healthy individuals at the doses tested.
抗抑郁药常用于功能性消化不良患者。然而,三环类抗抑郁药对饱腹感和胃排空的影响尚不清楚,且没有关于四环类化合物的数据。为比较去甲替林(最大剂量:每日50毫克)和米氮平(每日30毫克)与安慰剂对健康志愿者营养负荷后胃排空、胃饱腹感和餐后症状的影响。在健康志愿者中进行随机、双盲、安慰剂对照研究,评估去甲替林(n = 13)、米氮平(n = 13)或安慰剂(n = 14)治疗14天前后的胃功能。采用经过验证的方法研究胃排空((13)C - 辛酸酯)和营养饮料试验后的饱腹感。三组在年龄、性别、体重指数和医院焦虑/抑郁量表方面具有可比性。与安慰剂相比,米氮平或去甲替林对胃排空没有统计学显著影响(P = 0.34)。药物组和安慰剂组的最大耐受量相似(P = 0.56)。营养饮料激发后,安慰剂组在最大耐受量后30分钟的总症状评分为132(±21),米氮平组为165(±21),去甲替林50毫克组为126(±21)(P = 0.28)。在测试剂量下,三环类和四环类抗抑郁药对健康个体营养负荷后的胃动力或饱腹感似乎没有显著影响。