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Mirtazapine appears beneficial to treat
patients suffering diarrhea-predominant irritable bowel syndrome (IBS-D).
As per the study published in “BioPsychoSocial Medicine”, mirtazapine was found to alleviate the gastrointestinal symptoms of patients with IBS-D. It was also found to improve the quality of life and psychological symptoms like anxiety. Investigators carried out this randomized double-blind placebo-controlled eight-week study to assess whether mirtazapine (5-HT3 receptor antagonist) is effective and safe to treat individuals suffering from IBS-D when compared to placebo.
The
study recruited 67 subjects fulfilling Rome IV criteria for IBS-D. Participants
were divided into either the mirtazapine arm (n = 34) or the placebo arm (n =
33). Individuals initiated 15 mg/day mirtazapine at bedtime for about 1 week.
After this, the dose was elevated to 30 mg/day for an additional seven-week. The
endpoints were alterations in (i) IBS Quality of Life, (ii) Hospital anxiety
and depression scale score (HADS), and (iii) the total IBS symptom severity
score (IBS-SSS).
Furthermore,
alterations in the diary-based symptoms scores including pain, urgency and
frequency of defecation, consistency of feces on 7-point Bristol Stool Form
Scale, bloating, and the number of days per week with pain, bloating, diarrhea,
or urgency, once during the one-week run-in period and last week of therapy
were noted. All the assessments were carried on an intention-to-treat (ITT)
assessment data set.
It was noted that in comparison with placebo,
mirtazapine displayed superior efficacy to reduce the severity of the IBS
symptoms. Moreover, at the end of the therapeutic period, all diary-derived
symptoms except bloating displayed remarkably greater improvement in the
mirtazapine-treated individuals vs. the placebo-treated individuals. Also,
mirtazapine illustrated good tolerability and was found to considerably improve
the individuals’ quality of life as well as anxiety.
Thus, mirtazapine appears to have promising advantages to
treat individuals with IBS-D, specifically subjects having concomitant
psychological symptoms.
BioPsychoSocial Medicine
A randomized, double-blind, placebo-controlled study to assess efficacy of mirtazapine for the treatment of diarrhea predominant irritable bowel syndrome
Alireza Khalilian et al.
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