Effect of mianserin on gastric sensorimotor function and gastric emptying: a randomized, placebo-controlled, double-blind, crossover study in healthy volunteers.

摘要

BACKGROUND: Antidepressants such as mianserin can improve symptoms in some functional dyspeptic patients but their mechanism of action remains unclear. We aimed to assess the effects of mianserin on gastric sensorimotor function in man. METHODS: In this randomized, placebo-controlled, double-blind, crossover study 12 healthy subjects (six men) underwent a gastric barostat study and a gastric emptying breath test after 7 days pretreatment with placebo or mianserin (20 mg; p.o.). Graded isobaric and isovolumetric distentions were performed to determine gastric compliance and sensitivity. Subsequently, intrabag pressure was held constant and the volume increase after administration of a liquid meal (200 mL; 300 kcal) was studied. Breath was sampled before and after ingestion of a test meal and half-emptying times for solids and liquids were determined from the breath samples. Mianserin was compared to placebo using t-tests and mixed model analysis (mean +/- SD). KEY RESULTS: Mianserin did not affect pressures or volumes needed to induce first perception or discomfort. During isovolumetric distensions compliance was decreased after mianserin treatment (1.8 +/- 0.4 vs 2.0 +/- 0.3 mmHg 100 mL(-1); P < 0.05). Premeal volumes were comparable in both treatment arms (221 +/- 99 vs 220 +/- 88 mL), but meal-induced relaxation during the first 30 min was significantly inhibited after mianserin treatment (F(6,40) = 2.58, P < 0.05). Mianserin did not affect either solid or liquid gastric emptying. CONCLUSIONS & INFERENCES: Mianserin does not alter gastric emptying rate or sensitivity to gastric distension, but inhibits gastric accommodation to a meal in its early phase. These observations provide no explanation for the effects of mianserin in functional dyspeptic patients.