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 nutrientvolume ingested or symptoms induced by the nutrient drink test in healthy volunteers.