[Treatment of refractory irritable bowel syndrome with subclinical dosage of antidepressants].
OBJECTIVE
To investigate the effect of antidepressant on irritable bowel syndrome (IBS).


METHODS
A self-control and follow-up study on subclinical dosage of antidepressants therapy (fluoxetine 10 mg/d, paroxetine 10 mg/d or doxepin 45 mg/d) for 9-12 wks in 46 patients with refractory IBS symptoms according to Rome II criteria was performed, the clinical outcomes were evaluated by scales changes of symptom-related-anxiety, severity index of symptom, and quality of life specific of IBS, as well as general psychiatric health by SCL-90 during treatment and follow-up periods.


RESULTS
All 46 cases completed therapy and first follow-up unit (12 wks after treatment) (FFU), at the end of FFU, clinical symptoms in all patients were improved (P < 0.01). Comparison of the scores of symptom-related-anxiety, index of symptom, and quality of life specific of IBS at the end of FFU with that at basal level, indexes of the severity (3.4 +/- 1.5 vs 1.8 +/- 0.84) and frequency (3.8 +/- 1.60 vs 2.0 +/- 0.76) of symptoms were subsided significantly (P < 0.01, respectively); the scores of symptom-anxiety questionnaire including body anxiety (16.04 +/- 1.65 vs 10.83 +/- 1.64, P < 0.001), cognitive anxiety (18.78 +/- 2.12 vs 11.17 +/- 1.89, P < 0.001), fear (15.80 +/- 1.76 vs 10.78 +/- 1.85, P < 0.001) and avoiding (15.47 +/- 1.53 vs 10.16 +/- 1.59, P < 0.001) were also subsided significantly. In the meantime, IBS-QoL improved significantly (P < 0.05), dysphoria, body image, interference with activity, health worry, social reaction and overall scores were improved significantly (P < 0.01, respectively). The status of general psychiatric health was also improved significantly (P < 0.01).


CONCLUSIONS
Treatment of refractory IBS with subclinical dosage antidepressant is rational and effective, However a further study on its mechanisms is suggested.
Wang
Wei-an
WA
Department of Gastroenterology, PUMC Hospital, CAMS, PUMC, Beijing 100730, China. wangweian@IBSChina.com
Qian
Jia-ming
JM
Pan
Guo-zong
GZ
D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage*; D004316:Doxepin / Q000008:administration & dosage; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000008:administration & dosage; D011788:Quality of Life
D000928:Antidepressive Agents; D005473:Fluoxetine; D004316:Doxepin; D017374:Paroxetine