Mehmet Latif GÜNEŞ, Esra YAZICI, AHMET BÜLENT YAZICI, Irmak FERAH, Elif ÇADIRCI

Antidepresan ilaçların gastrik ülser üzerine etkileri

Psikiyatri hekimleri günlük uygulamalarında hastalarının psikiyatrik bozuklarının yanında sık sık mide ile ilgili şikayetleri ile karşılaşırlar. Ülser başta depresyon olmak üzere psikiyatrik hastalıklara eşlik eden hastalıklardan biridir. Antidepresanların bir yandan gastrointestinal (GI) kanamaları da dahil olmak üzere kanamaları alevlendirebildiği diğer yandan ise ülser iyileşmesine yardımcı etkisinin olabildiği gösterilmiştir. Bu derlemede antidepresan ilaçların ülser tedavisi üzerindeki olumlu ya da olumsuz etkileri hakkında yapılan çalışmalar incelenmiştir. Buna göre trisiklik antidepresanlardan opipramol, amitriptilin, imipraminin ülserin iyileşmesine yardımcı olduğu anlaşılmıştır. Selektif Serotonin Gerialim İnhibitörleri grubu ilaçların genel olarak ülseri alevlendirdiği, fluvoksaminin ve fluoksetinin istisnai olarak ülseri azalttığı, Monoamin oksidaz inhibitörlerinden olan moklobemidin ve atipik antidepresanlar olan tianeptin ve mirtazapinin ülserin iyileşmesine yardımcı etkileri olduğu belirtilmiştir. Ülseri olan psikiyatri hastalarına uygun antidepresan seçiminde dikkatli olmak hem ülserin hem de depresyonun seyri açısından önemlidir

The effects of antidepressants on gastric ulcer

In their daily practice, psychiatrists often experience gastric complaints in patients beside psychiatric disorders. Peptic ulcer is one of the diseases, which accompany to psychiatric disorders including mainly depression. It is shown that antidepressants can inflame the bleedings including gastrointestinal (GI) bleedings, while they have positive effect on ulcer healing. In this review, studies, which conducted about the positive or negative effects of antidepressant drugs on ulcer treatment were examined. Accordingly; it was found that opipramol, amitriptyline, imipramine that of tricyclic antidepressants was found to be helpful in healing of the ulcer. It was stated that Selective Serotonin Reuptake Inhibitors generally inflamed ulcers, exceptionally fluvoxamine and fluoxetine reduced ulcer; moclobemide that of monoamine-oxidase inhibitor and tianeptine and mirtazapine that of atypical antidepressants had positive effect in ulcer healing. To be careful in choosing the appropriate antidepressant in psychiatric patients with gastric ulcer is important in the prognosis of both ulcer and depression.

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