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Tianeptine sodium (CAS 30123-17-2) treatment of IBS

Date : 2016/8/29 11:54:03

Antidepressants, such as tianeptine sodium(CAS 30123-17-2), can improve abdominal pain in patients with IBS, abdominal discomfort, mental disorder, abnormal bowel movements and other symptoms, improve quality of life, has been widely used in the treatment of IBS, but its reliability efficacy surviving controversy. Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorders, national prevalence rate of 5% to 20%, and seriously affect the quality of life of patients. At present the pathogenesis of IBS is not yet clear, and there may be increased visceral sensitivity in patients with central pain abnormalities. In this paper, we reviewed the progress of antidepressants on IBS.

Tricyclic antidepressants (TCAs) inhibit histamine (H1) receptors and muscarinic receptors play anticholinergic effects, and thus relieve pain, reduce intestinal secretion, treatment of diarrhea-type IBS (D-IBS ). But its side effects was significantly lower doses can also cause dry mouth, dry eyes, constipation, drowsiness, fatigue, etc., limit the use of TCAs. Selective 5-HT reuptake inhibitors (SSRIs) can specifically inhibit 5-HT reuptake regulate 5-HT concentrations, activation of neurons at the intestinal mucosa, promote intestinal secretion, their constipation type IBS (C-IBS) It has a good effect. However, Chojnacki et al found that, 5-HT reuptake agonist tianeptine sodium(CAS 30123-17-2) equally effective for IBS, which can increase nerve cells, platelets, intestinal cells to 5-HT reuptake, but does not affect NA and dopamine uptake, also reduced hypothalamic - pituitary - adrenal (HPA) axis response to stress, reduced visceral hypersensitivity, relieve pain, reduce the frequency of bowel movements, for D-IBS significant effect. In addition, inflammatory factors also participated in the study of the pathogenesis of IBS, Altschuler and other findings, antidepressants may directly or indirectly reduce the inflammatory cytokines (such as tumor necrosis factor -α, interleukin-6) by anti-H1 effect, so the regulation of intestinal mucosal inflammation, relieve IBS symptoms.

Peripherally acting antidepressants(such as tianeptine sodium(CAS 30123-17-2)): brain - gut axis abnormal reflex involved in the pathophysiology of IBS, which includes neurotransmitter serotonin (5-HT), noradrenaline (NA), corticotropin releasing factor ( CRF), opioids, etc., these substances can alter intestinal sensitivity and dynamic, where research on 5-HT is the most widely used. 5-HT mainly by the intestinal mucosal enterochromaffin cells involved in the secretion of the gastrointestinal tract, absorption, sensory and motor functions. Acting on the 5-HT receptor drugs can relieve intestinal smooth muscle spasm, reduce visceral sensitivity, adjust the intestinal power of the IBS patients had abdominal pain and bowel function improvement.