Contraversy in treating patient with depression having organic stomach disease

[abdulgani]

This is Abdul Gani from Kerala,india.if a person is known to have organic disease of stomach(peptic ulcer) and needs treatment for depression,which medication should've taken?As we all know commonly used ssri's can cause stomach upset and retrosternal burning and thus can aggravate u the disease.is that atypical antidepressants like mirtazapine should be tried.but on other side atypical antidepressants are not effective than ssri's.what is the solution for this.i need ur kind information doctor!

[Kobojunkie]

Check out this study on using TCAs instead

Abstract

The role of tricyclic antidepressants (TCAs) as agents for treatment of peptic ulcer disease is of growing interest. In both placebo-controlled clinical trials and comparative studies with cimetidine, TCAs have proved effective and safe as ulcer-healing agents. The mechanism of action by which TCAs produce healing has not been fully elucidated. In vivo studies in man have generally shown that TCAs decrease gastric acid secretion. In addition to their well-known anticholinergic properties, in vitro studies have indicated potent H1- and H2-receptor blocking activities for these agents. Separate from these effects on acid output, the antipain/depression effect of TCAs may be of benefit in certain patients with ulcers. Other advantages of these agents include their long half-lives, low cost, and readily available serum monitoring. Further clinical studies with detailed physiologic and psychologic observations and serum monitoring using TCAs in patients with peptic ulcer disease are needed.

. ncbi.nlm.nih.gov/pubmed/636...

[Gambit62]

Abdul, please note that HU provides forums that allow patients to share information and support each other - it is not a substitute for professional medical advice

[NFDK]

I am going to agree wholly with what Gambit62 said. I would however caution against Duloxetine (Cymbalta) in the aforementioned case. One of the worst side effects of this drug is acid reflux.