The Korean Journal of Gastroenterology :eISSN 2233-6869 / pISSN 1598-9992

 

Table. 3.

Central Neuromodulators for CAPS

Tricyclic antidepressants Selective serotonin reuptake inhibitors Serotonin-norepinephrine reuptake inhibitors
Drugs/dose Amitriptyline, nortriptyline, imipramine, desipramine 25-100 mg qd for all Paroxetine (10-40 mg qd), fluoxetine (10-40 mg qd), sertraline (50-150 mg), escitalopram (5-20 mg qd) Duloxetine (30-90 mg qd), venlafaxine (for pain 150-225 mg qd), milnacipran (50-100 mg bid)
Treatment targets Pain, depression (first line treatment when pain predominates) Pain, depression, panic, anxiety, obsessive compulsive disorder (anxiety, depression, phobic feature prominent) Pain, depression (first-line treatment when pain predominates and/or side effects from TCAs preclude treatment)
Adverse events Sedation, hypotension, lethargy, constipation, dry mouth/eyes, arrhythmias, weight gain, sex dysfunction Insomnia, agitation, diarrhea, night sweats, headache, weight loss, sexual dysfunction Nausea, agitation, dizziness, sleep disturbance, fatigue, liver dysfunction (rare)
Risk from overdose Moderate Low Minimal
Dose adjustment Yes Not usual Not usual

CAPS, centrally mediated abdominal pain syndrome; TCA, tricyclic antidepressants.

Korean J Gastroenterol 2021;77:277~284 https://doi.org/10.4166/kjg.2021.083
© Korean J Gastroenterol