Banihashem Seyed Shahab, Mofatioshieh Seyedeh Mahsa, Rastegar Reyhaneh, Sadeghi Amir
Department of Psychosomatic Medicine, Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Psychiatry. 2024 Jan 16;14:1297231. doi: 10.3389/fpsyt.2023.1297231. eCollection 2023.
To compare the efficacy of Duloxetine and Nortriptyline in alleviating the symptoms of severity, anxiety, depression and quality of life in patients with functional dyspepsia (FD).
We conducted a single-blinded 3-month trial of Duloxetine 20-30 mg daily in 20 patients and Nortriptyline 25 mg daily in 25 FD patients. The primary outcome measure was the severity of FD symptoms by Gastrointestinal symptoms rating scale. Secondary measures included Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Nepean Dyspepsia Index. the patients were measured in 3 stages.
45 patients with FD with a mean age of 37.18 ± 10.62 years participated in the study. The severity of symptoms was significantly lower in the Nortriptyline group than in the Duloxetine group after three months ( = 0.031). The level of anxiety ( = 0.049), depression ( = 0.045) and quality of life ( = 0.046) improved significantly after three months in the Duloxetine group compared to Nortriptyline. Mediation analysis using linear regression revealed a significant mediator role for anxiety. This mediation analysis revealed a 21.13% reduction in anxiety in the Duloxetine group.
While both medications demonstrated efficacy, Nortriptyline appeared to be superior in symptom reduction. Duloxetine exhibited more advantages compared to Nortriptyline in addressing anxiety and depression and enhancing the overall quality of life. Also, Duloxetine may have a noteworthy impact, contributing to a 20% reduction in FD symptoms by lowering anxiety levels.
比较度洛西汀和去甲替林在缓解功能性消化不良（FD）患者的严重程度、焦虑、抑郁症状及改善生活质量方面的疗效。
我们对20例患者每日服用20 - 30毫克度洛西汀以及25例FD患者每日服用25毫克去甲替林进行了为期3个月的单盲试验。主要结局指标是通过胃肠道症状评定量表评估FD症状的严重程度。次要指标包括汉密尔顿焦虑评定量表、汉密尔顿抑郁评定量表和内皮恩消化不良指数。对患者进行了3个阶段的测量。
45例平均年龄为37.18 ± 10.62岁的FD患者参与了研究。三个月后，去甲替林组的症状严重程度显著低于度洛西汀组（P = 0.031）。与去甲替林相比，度洛西汀组在三个月后焦虑水平（P = 0.049）、抑郁水平（P = 0.045）和生活质量（P = 0.046）有显著改善。使用线性回归的中介分析显示焦虑具有显著的中介作用。该中介分析显示度洛西汀组的焦虑水平降低了21.13%。
虽然两种药物都显示出疗效，但去甲替林在减轻症状方面似乎更具优势。在解决焦虑和抑郁以及提高总体生活质量方面，度洛西汀与去甲替林相比表现出更多优势。此外，度洛西汀可能具有显著影响，通过降低焦虑水平使FD症状减少20%。
