New regimen for treatment of irritable bowel syndrome with emphasis on Sulpride as the sole maintenance therapy
The efficiency and safety of Sulpirid (50 mg twice/daily) was assessed in 563 adult patients with 6 groups of patients with irritable bowel syndrome (IBS) who had failed dietary therapy. The groups included; patients without previous treatment (n: 137), patients who had received a muscarinic antagonists (n: 65), an anticholinergic/benzodiazepine combination (n: 187), a tricyclic antidepressants (n: 62), a selective serotonin reuptake inhibitors (SSRIs) (n: 48) and an antiflatulent (n: 64). Patients were assessed for 6 weeks. Sulpirid was effective and safe in safe in relieving the abdominalgia, anxiety, depression and bowel function. The overall success of Sulpride in treatment of IBS was 84%. Most patients who had failed muscarinic antagonists, antiflatulent and tricyclic antidepressants had > 95% improvement with Sulpride. The success was 88% in those who did not receive prior therapy while it was just 77% and 72% in those who had failed SSRIs and anticholinergic/benzodiazepine combination. In treatment-failures, a further 9.8% improvement was achieved with addition of a SSRI (Escitalopram) and an extra 3.4% with subsequent increase in Sulpride dose to 100 mg X 2 limiting failures to only 2.3%. Tolerance of treatment was good and side-effects developed in 11% patients. In conclusion: Sulpride is an effective and safe drug in IBS.
Keywords: Antidepressants, anxiolytics, irritable bowel syndrome, treatment, Sulpride
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