BACKGROUND & AIMS:Patients with functional gastrointestinal disorders treated with tricyclic antidepressants sometimes report nongastrointestinal symptoms; it is unclear whether these are drug side effects or reflect a behavioral tendency to report symptoms. We evaluated whether symptoms reported before treatment with a tricyclic antidepressant (desipramine) increased in number or worsened in severity after 2 weeks of treatment and assessed the baseline factors that predispose patients to report symptoms. METHODS:Female patients in a multicenter National Institutes of Health trial for functional bowel disorders completed a 15-item symptom questionnaire at baseline (before randomization), 2 weeks after they were givendesipramine (n = 81) or placebo (n = 40), and at study completion (12 weeks). Patients were asked about the severity and frequency of 15 symptoms. Results were analyzed from 57 patients givendesipramine who completed the questionnaires. RESULTS: Symptoms reported as side effects to have occurred more frequently and also worsened at week 2 in the group given desipramine included dizziness, dry mouth/thirstiness, lightheadedness, jittery feelings/tremors, and flushing. Symptoms that did not change in severity or showed improvement at week 2 in the group given desipramine included morning tiredness, nausea, blurred vision, headaches, appetite reduction, and trouble sleeping. Psychologic distress but not desipramine blood level correlated with symptom reporting. CONCLUSIONS: Most symptoms often attributed to side effects of desipramine were present before treatment; only a few, related to anticholinergic effects, worsened 2 weeks after treatment, suggesting that most so-called side effects were not associated specifically with desipramine use. Such symptoms might instead be associated with psychologic distress.
RCT Entities:
BACKGROUND & AIMS:Patients with functional gastrointestinal disorders treated with tricyclic antidepressants sometimes report nongastrointestinal symptoms; it is unclear whether these are drug side effects or reflect a behavioral tendency to report symptoms. We evaluated whether symptoms reported before treatment with a tricyclic antidepressant (desipramine) increased in number or worsened in severity after 2 weeks of treatment and assessed the baseline factors that predispose patients to report symptoms. METHODS: Female patients in a multicenter National Institutes of Health trial for functional bowel disorders completed a 15-item symptom questionnaire at baseline (before randomization), 2 weeks after they were given desipramine (n = 81) or placebo (n = 40), and at study completion (12 weeks). Patients were asked about the severity and frequency of 15 symptoms. Results were analyzed from 57 patients given desipramine who completed the questionnaires. RESULTS: Symptoms reported as side effects to have occurred more frequently and also worsened at week 2 in the group given desipramine included dizziness, dry mouth/thirstiness, lightheadedness, jittery feelings/tremors, and flushing. Symptoms that did not change in severity or showed improvement at week 2 in the group given desipramine included morning tiredness, nausea, blurred vision, headaches, appetite reduction, and trouble sleeping. Psychologic distress but not desipramine blood level correlated with symptom reporting. CONCLUSIONS: Most symptoms often attributed to side effects of desipramine were present before treatment; only a few, related to anticholinergic effects, worsened 2 weeks after treatment, suggesting that most so-called side effects were not associated specifically with desipramine use. Such symptoms might instead be associated with psychologic distress.
Authors: D A Drossman; W E Whitehead; B B Toner; N Diamant; Y J Hu; S I Bangdiwala; H Jia Journal: Am J Gastroenterol Date: 2000-04 Impact factor: 10.864
Authors: Albena Halpert; Christine B Dalton; Nicholas E Diamant; Brenda B Toner; Yuming Hu; Carolyn B Morris; Shrikant I Bangdiwala; William E Whitehead; Douglas A Drossman Journal: Am J Gastroenterol Date: 2005-03 Impact factor: 10.864
Authors: Douglas A Drossman; Brenda B Toner; William E Whitehead; Nicholas E Diamant; Chris B Dalton; Susan Duncan; Shelagh Emmott; Valerie Proffitt; Donna Akman; Karen Frusciante; Terry Le; Kim Meyer; Barbara Bradshaw; Kristi Mikula; Carolyn B Morris; Carlar J Blackman; Yuming Hu; Huanguang Jia; Jim Z Li; Gary G Koch; Shrikant I Bangdiwala Journal: Gastroenterology Date: 2003-07 Impact factor: 22.682
Authors: Lisa-Ann Fraser; Jonathan D Adachi; William D Leslie; David Goltzman; Robert Josse; Jerilynn Prior; Stephanie Kaiser; Nancy Kreiger; Christopher S Kovacs; Tassos P Anastassiades; Alexandra Papaioannou Journal: Ann Pharmacother Date: 2014-05-09 Impact factor: 3.154