Impact of selective serotonin receptor inhibitors on gastric histopathology in patients with depression

Abstract

Objective: Antidepressant medications such as Selective Serotonin Reuptake Inhibitors (SSRI) and Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) are used in the psychopharmacological treatment for various types conditions. This study aimed to investigate whether SSRIs and SNRIs could reduce gastric intestinal metaplasia. Material Methods: A total of 212 patients who underwent upper gastrointestinal endoscopy plus biopsy in our clinic and were using selective serotonin reuptake inhibitors and other potent serotonin reuptake inhibitors were included in the study. A control group was created with a total of 230 age and gender matched patients who underwent upper gastrointestinal endoscopy plus biopsy but had no SSRI or SNRI usage. Patients’ endoscopic and pathologic findings were recorded retrospectively and compared between the groups. Results: The patient group consisted of 180 (84.9%) male and 32 (15.1%) female patients, while the control group included 175 (76.1%) male and 55 (23.29%) female patients. There was a statistically significant difference between the groups in terms of gender (p=0.020). The rates of erythematous antral gastritis (p<0.001), peptic ulcer (p=0.019), erosive gastropathy (p=0.001) and duodenitis (p=0.002) were statistically significantly lower in the patient group compared to the control group. The rates of H.Pylori(p=0.002), intestinal metaplasia (p=0.013), neutrophil activity (acute inflammation) (p<0.001) and chronic inflammation (p<0.001) were lower in the case group compared to the control group. Conclusion: SSRIs/SNRIs may potentially be used in treating gastrointestinal inflammation and metaplasia. However, further prospective randomised studies with larger series are needed to support our findings.