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Treatment of Functional Abdominal Pain with Antidepressants.

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eMediNexus    18 April 2018

The objective of a study published in the Journal of Pediatric Gastroenterology and Nutrition was to investigate treatment efficacy, correlation of response to psychiatric factors, and impact of adverse effects of antidepressant use in regard to physicians prescribing patterns. This was a retrospective review between 2005 and 2013, in which children (5-21 years old) with functional abdominal pain treated with SSRI or TCA were enrolled. Of the 531 children with functional abdominal pain, 192 initiated SSRIs or TCAs while being followed by gastroenterology. It was found that 75% of the SSRI patients and 61% of TCA patients improved. In the logistic regression controlling for psychiatric factors, SSRI remained significant over TCA. Also, 48% patients with constipation received TCAs and 58% patients with diarrhea received SSRIs. Three SSRI patients reported gastrointestinal effects, all diarrheal-type symptoms, and 2 TCA patients reported gastrointestinal effects, both constipation; in all it led to discontinuation. Meanwhile, 29% of diarrheal-type patients reported adverse effects causing discontinuation as compared to only 8% in the constipation group. Overall, 25% SSRI patients reported adverse effects with 6% reporting mood disturbances. Furthermore, 22% of TCA patients reported adverse effects, with 14% having mood disturbances. On the other hand, 14% of SSRI patients discontinued medication due to adverse effects, compared to 17% of TCA patients. From the results, it was concluded that patients show significantly greater response to SSRIs than TCAs, remaining significant after controlling for psychiatric factors.

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