title: The effects of paroxetine and amitriptyline on the upper esophageal sphincter (UES) pressure and its natural history in globus pharyngeus.
abstract: BACKGROUND
  Antidepressant agents have been shown to be an effective and safe treatment method for patients with globus. However, there are few clinical trials dedicated to studying the effects of antidepressant agents on the natural history and upper oesophageal sphincter (UES) pressure of treated globus patients.
  
  
  OBJECTIVE
  To evaluate the effect of paroxetine and amitriptyline to prevent relapses in patients with globus, the simultaneous relationship between changes in UES pressure and improvement of globus symptoms were measured.
  
  
  METHODS
  Globus patients were randomised into amitriptyline, paroxetine and lansoprazole groups for a 6-week treatment period, and follow-up was extended to 12 additional months. Efficacy was evaluated in terms of the Glasgow-Edinburgh Throat Scale (GETS), and UES pressure was measured by standard oesophageal manometry.
  
  
  RESULTS
  Paroxetine therapy resulted in a higher withdrawal rate due to symptom relapse (15.9% vs 44.1%, P=0.01; 15.9% vs 64.7, P=0.001) than amitriptyline and lansoprazole. Furthermore, globus symptoms were alleviated with the decrease of UES pressure after paroxetine and amitriptyline treatment (r=0.620, P=0.02; r=0.575, P=0.03) CONCLUSIONS: This follow-up study indicates that paroxetine may alter the natural history of globus and can effectively be used for the long-term management of patients with the disease. Apart from the clinical benefits, paroxetine and amitriptyline can potentially decrease UES pressure.
authors.affiliation: Department of Gastroenterology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
authors.forename: Wen-Cong
authors.initials: WC
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China; Department of Gastroenterology, Guangzhou Nansha Central Hospital Affiliated to Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China. Electronic address: 13925012853@139.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Jia
authors.affiliation: Department of Gastroenterology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
authors.forename: Dong-Yun
authors.initials: DY
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Guangzhou Nansha Central Hospital Affiliated to Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Guangzhou Nansha Central Hospital Affiliated to Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Shu-Man
authors.initials: SM
authors.lastname: Jiang
authors.affiliation: Department of Gastroenterology, Guangzhou Nansha Central Hospital Affiliated to Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Psychology, Guangzhou Nansha Central Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D000639:Amitriptyline / Q000008:administration & dosage / Q000494:pharmacology*; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D049631:Esophageal Sphincter, Upper / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D064747:Lansoprazole / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D017374:Paroxetine / Q000008:administration & dosage / Q000494:pharmacology*; D010608:Pharyngeal Diseases / Q000188:drug therapy*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D000639:Amitriptyline; D017374:Paroxetine
keywords: Antidepressants; Globus pharyngeus; Natural history; UES