Saudi Journal of Gastroenterology
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LETTER TO EDITOR  
Year : 2014  |  Volume : 20  |  Issue : 5  |  Page : 327
Depression and anxiety disorders among gastroenterologic outpatients


Department of Internal Medicine, Gulhane School of Medicine, 06018 Ankara, Turkey

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Date of Web Publication25-Sep-2014
 

How to cite this article:
Tasci I, Safer U. Depression and anxiety disorders among gastroenterologic outpatients. Saudi J Gastroenterol 2014;20:327

How to cite this URL:
Tasci I, Safer U. Depression and anxiety disorders among gastroenterologic outpatients. Saudi J Gastroenterol [serial online] 2014 [cited 2019 Jul 22];20:327. Available from: http://www.saudijgastro.com/text.asp?2014/20/5/327/141702


Sir,

Studies have shown that subjects with depression have altered secretion of ghrelin, a well-characterized, appetite-stimulating hormone produced in gastrointestinal system. Although blood ghrelin response is diminished after meal in untreated subjects with depression, it increases after appropriate antidepressive treatment. [1],[2] Moreover, gastrointestinal hormones, including leptin and ghrelin, also have systemic effects, and their metabolism is altered in certain gastrointestinal system disorders. [3]

Therefore, through even this single view, successful treatment of patients with depression seems to be required to increase long-term wellbeing. Recently, Alosaimi et al. reported that depression and anxiety were quite common in gastroenterologic outpatients, especially in those who had a chronic course of multiple gastrointestinal complaints. [4] Like some other previous reports, this study once more suggested the necessity of collaborations between gastroenterologists and psychiatrists. Otherwise, the clinicians will continue with acid-blocking agents and others that are now recognized for significant side effects when taken for long periods. [5] On the other hand, in the routine, psychiatrists are prone to guide treatment response to antidepressants using mainly behavioral changes. Therefore, patient-based contact with a psychiatrist may improve management of gastrointestinal symptoms in the outpatient setting. Moreover, in future, gastroenterologists might add depression medications to their own practice to increase patient comfort and reduce the time of acid blocker use.

However, we are also yet unsure whether selective serotonin reuptake inhibitors that are used widely to treat depression is safe for the gastrointestinal system, [6] or older but still used H2-receptor antagonists can cause central nervous system symptoms (mental confusion, headache, and depression). [7]

 
   References Top

1.Paslakis G, Westphal S, Hamann B, Gilles M, Lederbogen F, Deuschle M. Unstimulated and glucose-stimulated ghrelin in depressed patients and controls. J Psychopharmacol 2014;28:582-6.  Back to cited text no. 1
    
2.Pinar M, Gulsun M, Tasci I, Erdil A, Bolu E, Acikel C, et al. Maprotiline induced weight gain in depressive disorder: Changes in circulating ghrelin and adiponectin levels and insulin sensitivity. Prog Neuropsychopharmacol Biol Psychiatry 2008;32:135-9.  Back to cited text no. 2
    
3.Albaker WI. Helicobacter pylori infection and its relationship to metabolic syndrome: Is it a myth or fact? Saudi J Gastroenterol 2011;17:165-9.  Back to cited text no. 3
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4.Alosaimi FD, Al-Sultan O, Alghamdi Q, Almohaimeed I, Alqannas S. Association of help-seeking behavior with depression and anxiety disorders among gastroenterological patients in Saudi Arabia. Saudi J Gastroenterol 2014;20:233-40.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.Marcum ZA, Vande Griend JP, Linnebur SA. FDA drug safety communications: A narrative review and clinical considerations for older adults. Am J Geriatr Pharmacother 2012;10:264-71.  Back to cited text no. 5
    
6.Yuan Y, Tsoi K, Hunt RH. Selective serotonin reuptake inhibitors and risk of upper GI bleeding: Confusion or confounding? Am J Med 2006;119:719-27.  Back to cited text no. 6
    
7.Sax MJ. Clinically important adverse effects and drug interactions with H2-receptor antagonists: An update. Pharmacotherapy 1987;7:110-5S.  Back to cited text no. 7
    

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Correspondence Address:
Ilker Tasci
Department of Internal Medicine, Gulhane School of Medicine, 06018 Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.141702

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