Abstract
The clinical practice of adding antidepressant drugs to the therapy for the eradication of Helicobacter pylori (H. pylori) in addition to the standard drug regimen is not yet well established. This study aims to establish if there is an association between H. pylori gastritis and depression and to further analyze the therapeutic effect of antidepressants on symptomatic relief in gastritis. A systematic review was done using articles collected within the last seven years without regional or language localization obtained using PubMed, PubMed Central® (PMC), Google Scholar, and the Cochrane controlled trials. The search terms included Helicobacter pylori, depression, functional dyspepsia, and antidepressants. We selected three randomized controlled trials (RCTs), eight cross-sectional studies, four prospective studies, one cohort study, and two review articles. Trials that were prescribed antidepressants for clinical improvement of dyspepsia in patients with H. pylori gastritis that showed no improvement after eradication therapy standard regimen were included. In conclusion, patients who showed no improvement in functional dyspepsia after H. pylori eradication were seen to improve on antidepressant therapy. Further investigation and studies to analyze this correlation are recommended.
Highlights
BackgroundA 24-year-old female patient, on her third visit to our clinic, presented with complaints of epigastric pain and dyspepsia for more than a 10-month duration
This study aims to establish if there is an association between H. pylori gastritis and depression and to further analyze the therapeutic effect of antidepressants on symptomatic relief in gastritis
We suggest that the refractory H. pylori infection is strongly related to depression, in that functional dyspepsia is a common symptom among patients having associated H. pylori infection
Summary
A 24-year-old female patient, on her third visit to our clinic, presented with complaints of epigastric pain and dyspepsia for more than a 10-month duration. The patient had undergone an upper-endoscopy and subsequent biopsy, which was revealed on pathological examination and found to be consistent with H. pylori chronic gastritis She was on a triple therapy regimen with a multi-modal approach over the last ten months, which included 14 days of protocolbased management, following which no improvement in her symptoms was seen. Immunohistochemistry tests might be necessary for the detection of H. pylori organisms in patients on antibiotic therapy, chronic PPI therapy, or with other hypochlorhydria states that are predisposed to gastric bacterial overgrowth [5,6,7,8]. The keywords used for the search were: Helicobacter pylori (H. pylori) gastritis, depression, antidepressant drugs, stomach, brain, serotonin, dyspepsia, and anxiety. Data that was used strongly correlate the association between the trilogy H. pylori, depression and functional dyspepsia, and recommends the addition of antidepressant medications to the standard regimen therapy to treat H. pylori.
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