"It doesn't do any harm, but patients feel better": a qualitative exploratory study on gastroenterologists' perspectives on the role of antidepressants in inflammatory bowel disease

Background: Interest in psychological factors in patients with inflammatory bowel disease (IBD) has increased in recent years. It has even been proposed that treating psychological co-morbidities with antidepressants may control disease activity and improve quality of life. Despite this, there is no data on gastroenterologists' attitudes to, and experiences with, antidepressant therapy in patients with IBD. Methods: We conducted semi-structured interviews with 18 gastroenterologists associated with metropolitan teaching hospitals. Qualitative content analysis was used to examine their responses. Results: Seventy-eight percent of gastroenterologists had treated IBD patients with antidepressants for pain, depression and/or anxiety, and insomnia. Antidepressants were reported to be useful in improving psychosocial well-being, quality of life, and self-management of the disease by patients. However, in this group of gastroenterologists, there appears to be skepticism towards psychological disorders themselves or antidepressant therapy having a central role in either the causation of IBD or its clinical course. Nevertheless, these gastroenterologists were receptive to the idea of conducting a trial of the role of antidepressants in IBD. Conclusion: While the majority of specialists have treated IBD patients with antidepressants, there is considerable skepticism with regard to efficacy of antidepressive therapy or the role of psychological factors in the outcome of IBD patients.Antonina A Mikocka-Walus, Deborah A Turnbull, Nicole T Moulding, Ian G Wilson, Jane M Andrews and Gerald J Holtman

Efeitos comportamentais e imunológicos da fluoxetina em ratos submetidos ao nado forçado

No presente trabalho, os efeitos comportamentais e imunomoduladores da fluoxetina foram avaliados num modelo animal de depressão, o nado forçado. Nesse, o comportamento de flutuar é sensível a antidepressivos e é usado como índice de desespero comportamental. Foram utilizados dois grupos experimentais, sendo um grupo controle tratado com salina e outro grupo teste tratado com a fluoxetina, ambos administrados por via intra-peritoneal. Os animais foram tratados três vezes ao dia por 12 dias. Adicionalmente, a resposta imune humoral a uma imunoestimulação (hemácias de carneiro) foi avaliada. A fluoxetina provocou aumento no tempo em flutuação, queda na massa corporal e menor produção total de anticorpos. Os resultados indicam uma modulação simultânea do comportamento e do sistema imunológico pela fluoxetina