title: Paroxetine to treat irritable bowel syndrome not responding to high-fiber diet: a double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  The purpose of the trial was to determine whether a high-fiber diet (HFD) alone or in combination with paroxetine or placebo was effective treatment for patients with irritable bowel syndrome (IBS).
  
  
  METHODS
  
  
  
  METHODS
  Trial of HFD alone (Group 1) followed by a randomized, double-blind trial of HFD with paroxetine or placebo (Group 2).
  
  
  METHODS
  Gastroenterology office in a 524-bed university-affiliated community hospital in Pittsburgh.
  
  
  METHODS
  Men and women, aged 18-65 yr, previously diagnosed with IBS but otherwise healthy.
  
  
  METHODS
  Institution of HFD in 98 participants consuming low- or average-fiber diets. Allocation of paroxetine to 38 and placebo to 43 symptomatic participants consuming HFDs.
  
  
  METHODS
  Overall well-being, abdominal pain, and abdominal bloating (Groups 1 and 2); food avoidance, work functioning, and social functioning (Group 2).
  
  
  RESULTS
  In Group 1, overall well-being improved in 26% patients, and abdominal pain and bloating decreased in 22% and 26% patients, respectively, with an HFD. In Group 2, overall well-being improved more with paroxetine than with placebo (63.3%vs 26.3%; p= 0.01), but abdominal pain, bloating, and social functioning did not. With paroxetine, food avoidance decreased (p= 0.03) and work functioning was marginally better (p= 0.08). Before unblinding, more paroxetine recipients than placebo recipients wanted to continue their study medication (84%vs 37%; p < 0.001).
  
  
  CONCLUSIONS
  The difference in overall well-being found in our paroxetine/placebo trial is greater than that found in previously published drug/placebo trials for IBS. Moreover, the difference in well-being applied to nondepressed recipients of paroxetine.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Tabas
authors.forename: Mary
authors.initials: M
authors.lastname: Beaves
authors.forename: Jiping
authors.initials: J
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Friday
authors.forename: Houssam
authors.initials: H
authors.lastname: Mardini
authors.forename: George
authors.initials: G
authors.lastname: Arnold
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004043:Dietary Fiber / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000008:administration & dosage*; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D004043:Dietary Fiber; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors