Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpractice
IBD, a chronic inflammatory disease, has been manifested as a growing health problem. No Crohn’s and Colitis councils have officially ratified anti-depressants as a routine regimen for IBD patients. However, some physicians empirically prescribe them to rectify functional bowel consequences such as...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.980189/full |
| _version_ | 1828162586619674624 |
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| author | Mohammad Reza Hatamnejad Shaghayegh Baradaran Ghavami Marzieh Shirvani Mona Asghari Ahmadabad Shabnam Shahrokh Maryam Farmani Ghazal Sherkat Hamid Asadzadeh Aghdaei Mohammad Reza Zali |
| author_facet | Mohammad Reza Hatamnejad Shaghayegh Baradaran Ghavami Marzieh Shirvani Mona Asghari Ahmadabad Shabnam Shahrokh Maryam Farmani Ghazal Sherkat Hamid Asadzadeh Aghdaei Mohammad Reza Zali |
| author_sort | Mohammad Reza Hatamnejad |
| collection | DOAJ |
| description | IBD, a chronic inflammatory disease, has been manifested as a growing health problem. No Crohn’s and Colitis councils have officially ratified anti-depressants as a routine regimen for IBD patients. However, some physicians empirically prescribe them to rectify functional bowel consequences such as pain and alleviate psychiatric comorbidities. On the other side, SSRIs’ prescription is accompanied by adverse effects such as sleep disturbances. Prolonged intermittent hypoxia throughout sleep disturbance such as sleep apnea provokes periodic reductions in the partial oxygen pressure gradient in the gut lumen. It promotes gut microbiota to dysbiosis, which induces intestinal inflammation. This phenomenon and evidence representing the higher amount of serotonin associated with Crohn’s disease challenged our previous knowledge. Can SSRIs worsen the IBD course? Evidence answered the question with the claim on anti-inflammatory properties (central and peripheral) of SSRIs and illuminated the other substantial elements (compared to serotonin elevation) responsible for IBD pathogenesis. However, later clinical evidence was not all in favor of the benefits of SSRIs. Hence, in this review, the molecular mechanisms and clinical evidence are scrutinized and integrated to clarify the interfering molecular mechanism justifying both supporting and disproving clinical evidence. Biphasic dose-dependent serotonin behavior accompanying SSRI shifting function when used up for the long-term can be assumed as the parameters leading to IBD patients’ adverse outcomes. Despite more research being needed to elucidate the effect of SSRI consumption in IBD patients, periodic prescriptions of SSRIs at monthly intervals can be recommended. |
| first_indexed | 2024-04-12T00:57:23Z |
| format | Article |
| id | doaj.art-ecd7c636513b4e6a89a9d0910646c125 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-12T00:57:23Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-ecd7c636513b4e6a89a9d0910646c1252022-12-22T03:54:35ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.980189980189Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpracticeMohammad Reza Hatamnejad0Shaghayegh Baradaran Ghavami1Marzieh Shirvani2Mona Asghari Ahmadabad3Shabnam Shahrokh4Maryam Farmani5Ghazal Sherkat6Hamid Asadzadeh Aghdaei7Mohammad Reza Zali8Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranBasic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranFaculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranFaculty of Medicine, Guilan University of Medical Sciences, Guilan, IranBasic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranBasic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranMedicine Faculty of Mashhad Branch, Islamic Azad University, Mashhad, IranBasic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranGastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranIBD, a chronic inflammatory disease, has been manifested as a growing health problem. No Crohn’s and Colitis councils have officially ratified anti-depressants as a routine regimen for IBD patients. However, some physicians empirically prescribe them to rectify functional bowel consequences such as pain and alleviate psychiatric comorbidities. On the other side, SSRIs’ prescription is accompanied by adverse effects such as sleep disturbances. Prolonged intermittent hypoxia throughout sleep disturbance such as sleep apnea provokes periodic reductions in the partial oxygen pressure gradient in the gut lumen. It promotes gut microbiota to dysbiosis, which induces intestinal inflammation. This phenomenon and evidence representing the higher amount of serotonin associated with Crohn’s disease challenged our previous knowledge. Can SSRIs worsen the IBD course? Evidence answered the question with the claim on anti-inflammatory properties (central and peripheral) of SSRIs and illuminated the other substantial elements (compared to serotonin elevation) responsible for IBD pathogenesis. However, later clinical evidence was not all in favor of the benefits of SSRIs. Hence, in this review, the molecular mechanisms and clinical evidence are scrutinized and integrated to clarify the interfering molecular mechanism justifying both supporting and disproving clinical evidence. Biphasic dose-dependent serotonin behavior accompanying SSRI shifting function when used up for the long-term can be assumed as the parameters leading to IBD patients’ adverse outcomes. Despite more research being needed to elucidate the effect of SSRI consumption in IBD patients, periodic prescriptions of SSRIs at monthly intervals can be recommended.https://www.frontiersin.org/articles/10.3389/fimmu.2022.980189/fullinflammatory bowel diseasesserotonin uptake inhibitorspro-inflammatoryanti-inflammatoryCrohn’s diseaseulcerative colitis |
| spellingShingle | Mohammad Reza Hatamnejad Shaghayegh Baradaran Ghavami Marzieh Shirvani Mona Asghari Ahmadabad Shabnam Shahrokh Maryam Farmani Ghazal Sherkat Hamid Asadzadeh Aghdaei Mohammad Reza Zali Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpractice Frontiers in Immunology inflammatory bowel diseases serotonin uptake inhibitors pro-inflammatory anti-inflammatory Crohn’s disease ulcerative colitis |
| title | Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpractice |
| title_full | Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpractice |
| title_fullStr | Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpractice |
| title_full_unstemmed | Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpractice |
| title_short | Selective serotonin reuptake inhibitors and inflammatory bowel disease; Beneficial or malpractice |
| title_sort | selective serotonin reuptake inhibitors and inflammatory bowel disease beneficial or malpractice |
| topic | inflammatory bowel diseases serotonin uptake inhibitors pro-inflammatory anti-inflammatory Crohn’s disease ulcerative colitis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.980189/full |
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