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March 1984

Tricyclic Antidepressant Therapy for Peptic Ulcer Disease

Author Affiliations

From the Department of Psychiatry and Behavior Sciences (Drs Ries and Katon) and the Division of Gastroenterology, the Department of Medicine (Dr Gilbert), University of Washington, Seattle.

Arch Intern Med. 1984;144(3):566-569. doi:10.1001/archinte.1984.00350150170037

• The role of tricyclic antidepressants (TCAs) as agents for treatment of peptic ulcer disease is of growing interest. In both placebo-controlled clinical trials and comparative studies with cimetidine, TCAs have proved effective and safe as ulcerhealing agents. The mechanism of action by which TCAs produce healing has not been fully elucidated. In vivo studies in man have generally shown that TCAs decrease gastric acid secretion. In addition to their well-known anticholinergic properties, in vitro studies have indicated potent H1- and H2receptor blocking activities for these agents. Separate from these effects on acid output, the antipain/depression effect of TCAs may be of benefit in certain patients with ulcers. Other advantages of these agents include their long half-lives, low cost, and readily available serum monitoring. Further clinical studies with detailed physiologic and psychologic observations and serum monitoring using TCAs in patients with peptic ulcer disease are needed.

(Arch Intern Med 1984;144:566-569)