Document Detail


Differential effects of two types of antidepressants, amitriptyline and fluoxetine, on anorectal motility and visceral perception.
MedLine Citation:
PMID:  15352918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although antidepressants are used for functional gastrointestinal disorders, the mechanisms of their effects on gut are incompletely understood. AIM: To assess the effects of two types of antidepressants (tricyclic, serotoninergic) on anorectal motility and visceral perception. METHODS: A placebo-controlled, randomized, double-blind, crossover study was performed in 12 healthy male volunteers who received a single oral dose of amitriptyline (80 mg), fluoxetine (40 mg) or placebo. Drug effects were assessed using phasic isobaric distensions of the rectum with an electronic barostat (11 levels from 1 to 51 mmHg) 4 h after drug intake. Maximal rectal volume and pressure, mean and residual pressures at upper anal canal, mean pressure at lower anal canal, defecation sensation (5-level scale) and visceral perception (visual analogue scale) were recorded at each level of distending pressure. RESULTS: Ten subjects completed the study. Compared with placebo, neither amitriptyline nor fluoxetine modified rectal compliance or visceral perception. Compared with placebo, antidepressants significantly reduced mean and residual pressures at upper anal canal (-18%, P = 0.0019, and -27%, P = 0.0002, respectively, for amitriptyline; -26%, P = 0.0001, and -33%, P = 0.0001, respectively, for fluoxetine) whereas only amitriptyline significantly reduced mean pressure at lower anal canal (-16%, P = 0.0008). CONCLUSION: Both antidepressants similarly relaxed the internal anal sphincter, probably through a non-specific mechanism, without modifying visceral perception. Only amitriptyline relaxed the external anal sphincter.
Authors:
L Siproudhis; M Dinasquet; V Sébille; J M Reymann; E Bellissant
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  20     ISSN:  0269-2813     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-08     Completed Date:  2004-12-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  689-95     Citation Subset:  IM    
Affiliation:
Service des Maladies de l'Appareil Digestif, CHU de Rennes et Université de Rennes 1, Hôpital de Pontchaillou, France. laurent.siproudhis@chu-rennes.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amitriptyline / pharmacology*
Anal Canal / drug effects*
Antidepressive Agents / pharmacology*
Antidepressive Agents, Second-Generation / pharmacology
Antidepressive Agents, Tricyclic / pharmacology
Cross-Over Studies
Double-Blind Method
Fluoxetine / pharmacology*
Gastrointestinal Motility / drug effects*
Humans
Male
Manometry
Perception
Viscera / drug effects*,  physiology
Chemical
Reg. No./Substance:
0/Antidepressive Agents; 0/Antidepressive Agents, Second-Generation; 0/Antidepressive Agents, Tricyclic; 50-48-6/Amitriptyline; 54910-89-3/Fluoxetine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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