Clinical Trials Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2016; 22(22): 5260-5266
Published online Jun 14, 2016. doi: 10.3748/wjg.v22.i22.5260
Beneficial effects of antidepressant mirtazapine in functional dyspepsia patients with weight loss
Shu-Man Jiang, Lin Jia, Jing Liu, Man-Man Shi, Ming-Zhi Xu
Shu-Man Jiang, Lin Jia, Jing Liu, Man-Man Shi, Department of Gastroenterology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong Province, China
Shu-Man Jiang, Lin Jia, Jing Liu, Man-Man Shi, Department of Gastroenterology, Guangzhou Nansha Central Hospital, Guangzhou 510180, Guangdong Province, China
Ming-Zhi Xu, Department of Psychology, Guangdong General Hospital, Guangzhou 510080, Guangdong Province, China
Author contributions: Jiang SM and Jia L designed the research; Liu J, Shi MM and Xu MZ performed the research; Jiang SM, Jia L and Liu J analyzed the data; Jiang SM and Jia L wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Guangzhou First People’s Hospital and Guangzhou Nansha Central Hospital.
Clinical trial registration statement: This registration policy applies to prospective, randomized, controlled trials only.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Not declared.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lin Jia, MD, Department of Gastroenterology, Guangzhou First People’s Hospital, Guangzhou Medical University, No. 1 Panfu Road, Guangzhou 510180, Guangdong Province, China. 13925012853@139.com
Telephone: +86-20-81628809 Fax: +86-20-81628809
Received: February 24, 2016
Peer-review started: February 25, 2016
First decision: March 7, 2016
Revised: April 6, 2017
Accepted: April 15, 2016
Article in press: April 15, 2016
Published online: June 14, 2016
Processing time: 98 Days and 18.5 Hours
Abstract

AIM: To explore the effects and mechanism of action of antidepressant mirtazapine in functional dyspepsia (FD) patients with weight loss.

METHODS: Sixty depressive FD patients with weight loss were randomly divided into a mirtazapine group (MG), a paroxetine group (PG) or a conventional therapy group (CG) for an 8-wk clinical trial. Adverse effects and treatment response were recorded. The Nepean Dyspepsia Index-symptom (NDSI) checklist and the 17-item Hamilton Rating Scale of Depression (HAMD-17) were used to evaluate dyspepsia and depressive symptoms, respectively. The body composition analyzer was used to measure body weight and fat. Serum hormone levels were measured by ELISA.

RESULTS: (1) After 2 wk of treatment, NDSI scores were significantly lower for the MG than for the PG and CG; (2) After 4 or 8 wk of treatment, HAMD-17 scores were significantly lower for the MG and PG than for the CG; (3) After 8 wk of treatment, patients in the MG experienced a weight gain of 3.58 ± 1.57 kg, which was significantly higher than that observed for patients in the PG and CG. Body fat increased by 2.77 ± 0.14 kg, the body fat ratio rose by 4%, and the visceral fat area increased by 7.56 ± 2.25 cm2; and (4) For the MG, serum hormone levels of ghrelin, neuropeptide Y (NPY), motilin (MTL) and gastrin (GAS) were significantly upregulated; in contrast, those of leptin, 5-hydroxytryptamine (5-HT) and cholecystokinin (CCK) were significantly downregulated.

CONCLUSION: Mirtazapine not only alleviates symptoms associated with dyspepsia and depression linked to FD in patients with weight loss but also significantly increases body weight (mainly the visceral fat in body fat). The likely mechanism of mirtazapine action is regulation of brain-gut or gastrointestinal hormone levels.

Keywords: Mirtazapine; Functional dyspepsia; Weight loss; Depression

Core tip: A part of functional dyspepsia (FD) patients were found with weight loss in recent studies. As an antidepressant, mirtazapine was found not only to alleviate symptoms associated with dyspepsia and depression linked to FD with weight loss, but also to significantly increase body weight (mainly the visceral fat in body fat). Moreover, the likely mechanism of mirtazapine action is the regulation of brain-gut or gastrointestinal hormone levels.