title: Central Neuromodulators for Treating Functional GI Disorders: A Primer.
abstract: Patients with functional GI disorders (FGIDs) are commonplace in the gastroenterologist's practice. A number of these patients may be refractory to peripherally acting agents, yet respond to central neuromodulators. There are benefits and potential adverse effects to using TCAs, SSRIs, SNRIs, atypical antipsychotics, and miscellaneous central neuromodulators in these patients. These agents can benefit mood, pain, diarrhea, constipation, nausea, sleep, and depression. The mechanisms by which they work, the differences between classes and individual agents, and the various adverse effects are outlined. Dosing, augmentation strategies, and treatment scenarios specifically for painful FGIDs, FD with PDS, and chronic nausea and vomiting syndrome are outlined.
authors.affiliation: United Hospital System, Kenosha, Wisconsin, USA.
authors.forename: W Harley
authors.initials: WH
authors.lastname: Sobin
authors.affiliation: Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Heinrich
authors.affiliation: Center for Education and Practice of Biopsychosocial Care and Drossman Gastroenterology, Chapel Hill, North Carolina, USA.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Drossman
mesh_terms: D000929:Antidepressive Agents, Tricyclic / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002983:Clinical Competence; D003672:Defecation / Q000187:drug effects; D005767:Gastrointestinal Diseases / Q000188:drug therapy*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy; D018377:Neurotransmitter Agents / Q000494:pharmacology / Q000627:therapeutic use*; D020230:Serotonin Syndrome / Q000139:chemically induced; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D018377:Neurotransmitter Agents; D017367:Selective Serotonin Reuptake Inhibitors; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors