Beneficial effects of antidepressant mirtazapine in functional dyspepsia patients with weight loss

• Published in: World journal of gastroenterology : WJG Vol. 22; no. 22; pp. 5260 - 5266
• Main Authors: Jiang, Shu-Man, Jia, Lin, Liu, Jing, Shi, Man-Man, Xu, Ming-Zhi
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 14.06.2016
• Subjects: Adiposity - drug effects; Adult; Affect - drug effects; Antidepressive Agents, Second-Generation - adverse effects; Antidepressive Agents, Second-Generation - therapeutic use; Antidepressive Agents, Tricyclic - adverse effects; Antidepressive Agents, Tricyclic - therapeutic use; Checklist; China; Clinical Trials Study; Depression - blood; Depression - diagnosis; Depression - drug therapy; Depression - psychology; Dyspepsia - blood; Dyspepsia - diagnosis; Dyspepsia - drug therapy; Dyspepsia - physiopathology; dyspepsia;weight; Female; Hormones - blood; Humans; Intra-Abdominal Fat - drug effects; Intra-Abdominal Fat - physiopathology; loss;Depression; Male; Mianserin - adverse effects; Mianserin - analogs & derivatives; Mianserin - therapeutic use; Middle Aged; Mirtazapine;Functional; Paroxetine - adverse effects; Paroxetine - therapeutic use; Prospective Studies; Psychiatric Status Rating Scales; Time Factors; Treatment Outcome; Weight Loss - drug effects; Mirtazapine; Depression; Functional dyspepsia; Weight loss
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i22.5260

AIM: To explore the effects and mechanism of action of antidepressant mirtazapine in functional dyspepsia(FD) patients with weight loss.METHODS: Sixty depressive FD patients with weight loss were randomly divided into a mirtazapine group(MG), a paroxetine group(PG) or a conventional therapy group(CG) for an 8-wk clinical trial. Adverse effects and treatment response were recorded. The Nepean Dyspepsia Index-symptom(NDSI) checklist and the 17-item Hamilton Rating Scale of Depression(HAMD-17) were used to evaluate dyspepsia and depressive symptoms, respectively. The body composition analyzer was used to measure body weight and fat. Serum hormone levels were measured by ELISA.RESULTS:(1) After 2 wk of treatment, NDSI scores were significantly lower for the MG than for the PG and CG;(2) After 4 or 8 wk of treatment, HAMD-17 scores were significantly lower for the MG and PG than for the CG;(3) After 8 wk of treatment, patients in the MG experienced a weight gain of 3.58 ± 1.57 kg, which was significantly higher than that observed for patients in the PG and CG. Body fat increased by 2.77 ± 0.14kg, the body fat ratio rose by 4%, and the visceral fat area increased by 7.56 ± 2.25 cm2; and(4) For the MG, serum hormone levels of ghrelin, neuropeptide Y(NPY), motilin(MTL) and gastrin(GAS) were significantly upregulated; in contrast, those of leptin, 5-hydroxytryptamine(5-HT) and cholecystokinin(CCK) were significantly downregulated. CONCLUSION: Mirtazapine not only alleviates symptoms associated with dyspepsia and depression linked to FD in patients with weight loss but also significantly increases body weight(mainly the visceral fat in body fat). The likely mechanism of mirtazapine action is regulation of brain-gut or gastrointestinal hormone levels.