Articles: serotonin-agents-therapeutic-use.
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Irritable bowel syndrome refers to abdominal discomfort associated with altered bowel habits. Recent evidence suggests that the primary pathophysiologic mechanism is brain-gut dysregulation. Many central and peripheral factors are involved. This article will review important pathophysiologic mechanisms with a focus on new and emerging therapies. ⋯ A better understanding of pathophysiologic mechanisms has resulted in therapeutic advances. Prokinetic therapies may have a role in nondiarrhea predominant irritable bowel syndrome. Antidepressants are used to modulate pain and treat comorbid psychological distress. Newer agents target various receptor sites. Advances in psychological/behavioral treatments and alternative modalities hold promise for the future.
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The association between migraine and functional gastrointestinal disorders has been confirmed by many clinical observations and epidemiological studies. In most patients during the attacks of migraine, apart from various neurological and vascular symptoms, gastrointestinal disturbances occur including nausea, vomiting, abdominal pain or diarrhea. Functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), are reported in migraine patients in periods between the attacks as well. ⋯ Nowadays, agonists and antagonists of serotoninergic receptors are the most efficacious drugs for IBS and migraine therapy. Some side effects of triptans, 5-HT(1B/D) agonists, used in migraine treatment may be connected with the influence of triptans on the gastrointestinal functions. A better understanding of the relationship between migraine and IBS may result in more effective treatment of both diseases.
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Expert Opin Investig Drugs · May 2003
ReviewThe role of 5-HT on the cardiovascular and renal systems and the clinical potential of 5-HT modulation.
The main peripheral sources of 5-hydroxytryptamine (5-HT) are as a neurotransmitter and local hormone in the gastrointestinal tract, and stored in circulating platelets and pulmonary neuroepithelial bodies. 5-HT has been shown to have many possible physiological and pathophysiological roles on the cardiovascular and renal systems. Thus, 5-HT may contribute to valvular heart disease, coronary artery disease, pulmonary hypertension, pulmonary embolism, pre-eclampsia, peripheral vascular disease and diabetic nephropathy. Consequently, modulators of the 5-HT system have diverse clinical potential. ⋯ MCI-9042 (sarpogrelate) or other 5-HT(2A) antagonists may have clinical potential for the treatment of vasospastic angina, ischaemic heart disease, reperfusion injury and hindlimb ischaemia. Several modulators of 5-HT (5-HT transporter inhibitors, 5-HT(1B) and (2B) antagonists) may have potential alone or in combination in the treatment of pulmonary hypertension. In hypertension, agonists at the 5-HT(7) and antagonists at the 5-HT(2B) may reduce blood pressure, and in diabetes, sarpogrelate may protect against nephropathy.