Effects of desipramine and escitalopram on postprandial symptoms induced by the nutrient drink test in healthy volunteers: a randomized, double-blind, placebo-controlled study.
BACKGROUND
Antidepressants are widely used to treat functional gastrointestinal disorders but their effect on postprandial symptoms remains unstudied. We hypothesized that desipramine and escitalopram would enhance the maximum tolerated volume of nutrient ingested and decrease postprandial symptoms.


METHODS
Healthy participants (n=45) all underwent an assessment of symptoms, anxiety and depression, and a standard nutrient drink test (Ensure). Participants were randomized to 11 days of desipramine (50 mg once daily), escitalopram (10 mg once daily) or identical placebo.


RESULTS
The maximum tolerated gastric volumes were not significantly different on day 11 for desipramine (1,136+/-478 ml, mean+/-SD), escitalopram (1,198+/-422 ml) and placebo (1,231+/-318 ml). A univariate analysis indicated significant treatment group effects on total symptom scores (p=0.049), but after adjusting for age, gender, BMI and baseline scores, treatment effects were no longer significant (p=0.15).


CONCLUSIONS
While this study does not rule out a beneficial effect of tricyclics or selective serotonin reuptake inhibitors in functional dyspepsia, neither desipramine nor escitalopram significantly altered the nutrient volume ingested or symptoms induced by the nutrient drink test in healthy volunteers.
Talley
Nicholas J
NJ
Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN 55905, USA. talley.nicholas@mayo.edu
Camilleri
Michael
M
Chitkara
Denesh K
DK
Bouras
Ernest
E
Locke
G Richard
GR
Burton
Duane
D
Rucker
Mary Jo
MJ
Thapa
Prabin
P
Zinsmeister
Alan R
AR
D000328:Adult; D000704:Analysis of Variance; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage*; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage*; D015283:Citalopram / Q000008:administration & dosage*; D003891:Desipramine / Q000008:administration & dosage*; D019422:Dietary Sucrose; D004311:Double-Blind Method; D004415:Dyspepsia / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005526:Food, Formulated; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D008297:Male; D019518:Postprandial Period; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D019422:Dietary Sucrose; D015283:Citalopram; C082131:Ensure formulated food; D003891:Desipramine