title: Effects of desipramine and escitalopram on postprandial symptoms induced by the nutrient drink test in healthy volunteers: a randomized, double-blind, placebo-controlled study.
abstract: 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.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN 55905, USA. talley.nicholas@mayo.edu
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: Michael
authors.initials: M
authors.lastname: Camilleri
authors.forename: Denesh K
authors.initials: DK
authors.lastname: Chitkara
authors.forename: Ernest
authors.initials: E
authors.lastname: Bouras
authors.forename: G Richard
authors.initials: GR
authors.lastname: Locke
authors.forename: Duane
authors.initials: D
authors.lastname: Burton
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Rucker
authors.forename: Prabin
authors.initials: P
authors.lastname: Thapa
authors.forename: Alan R
authors.initials: AR
authors.lastname: Zinsmeister
mesh_terms: 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
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D019422:Dietary Sucrose; D015283:Citalopram; C082131:Ensure formulated food; D003891:Desipramine