TY - JOUR
T1 - Psychotropic agents in functional gastrointestinal disorders
AU - Grover, Madhusudan
AU - Drossman, Douglas A.
N1 - Funding Information:
This work was supported by NIH Grant R24 DK067674.
PY - 2008/12
Y1 - 2008/12
N2 - Functional gastrointestinal disorders (FGIDs) are common conditions diagnosed by established symptom-based criteria. Dysregulation of the brain-gut axis is emerging as the primary pathophysiologic mechanism for FGIDs; this opens avenues for newer treatment modalities. Psychotropic agents act on a variety of neurotransmitter receptors in the brain-gut regulatory pathways that target serotonergic, dopaminergic, opioidergic, and noradrenergic receptor sites. The role of psychotropic agents, especially tricyclic antidepressants is fairly well established in the management of FGIDs and benefit from the newer serotonin norepinephrine reuptake inhibitors is promising. Selective serotonin reuptake inhibitors may provide benefit by reducing symptom anxiety and achieve global symptom relief. In spite of expanding research in evaluating these potential agents, there remains an unmet need in pharmacological management of these disorders, especially at the severe end of their spectrum where options for combined treatments or augmentation need to be developed. In addition, the understanding and management of these disorders hinges on a multidisciplinary biopsychosocial approach, which itself can be a challenging strategy.
AB - Functional gastrointestinal disorders (FGIDs) are common conditions diagnosed by established symptom-based criteria. Dysregulation of the brain-gut axis is emerging as the primary pathophysiologic mechanism for FGIDs; this opens avenues for newer treatment modalities. Psychotropic agents act on a variety of neurotransmitter receptors in the brain-gut regulatory pathways that target serotonergic, dopaminergic, opioidergic, and noradrenergic receptor sites. The role of psychotropic agents, especially tricyclic antidepressants is fairly well established in the management of FGIDs and benefit from the newer serotonin norepinephrine reuptake inhibitors is promising. Selective serotonin reuptake inhibitors may provide benefit by reducing symptom anxiety and achieve global symptom relief. In spite of expanding research in evaluating these potential agents, there remains an unmet need in pharmacological management of these disorders, especially at the severe end of their spectrum where options for combined treatments or augmentation need to be developed. In addition, the understanding and management of these disorders hinges on a multidisciplinary biopsychosocial approach, which itself can be a challenging strategy.
UR - http://www.scopus.com/inward/record.url?scp=55649116852&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=55649116852&partnerID=8YFLogxK
U2 - 10.1016/j.coph.2008.07.012
DO - 10.1016/j.coph.2008.07.012
M3 - Review article
C2 - 18760380
AN - SCOPUS:55649116852
SN - 1471-4892
VL - 8
SP - 715
EP - 723
JO - Current Opinion in Pharmacology
JF - Current Opinion in Pharmacology
IS - 6
ER -