Table 3 Commonly used medications for DGBI symptoms
From: Assessment and management of disorders of gut–brain interaction in patients with eating disorders
Name | Drug class | Dose | Therapeutic use | Adverse effects |
|---|---|---|---|---|
Secretagogues | ||||
Linaclotide | Guanylate Cyclase-C Agonist | 72–290 mcg QD | Constipation, abdominal pain | Diarrhea, abdominal distension, abdominal pain |
Lubiprostone | Chloride channel activator | 8–24 mcg BID | Constipation, abdominal pain | Nausea, diarrhea, headache |
Plecanatide | Guanylate Cyclase-C Agonist | 3 mg QD | Constipation, abdominal pain | Diarrhea, abdominal distension |
Tenapanor | Sodium-hydrogen exchanger inhibitor | 50 mg BID | Constipation, abdominal pain | Diarrhea, abdominal distension, dizziness |
Prokinetic Agents | ||||
Azithromycin | Motilin receptor agonist | 250–500 mg QD | Dyspepsia, gastroparesis | Tachyphylaxis, QT prolongation, abdominal pain |
Erythromycin | Motilin receptor agonist | 50 mg qAC and qHS | Dyspepsia, gastroparesis | Tachyphylaxis, QT prolongation, abdominal pain |
Domperidone | Dopamine receptor antagonist | 10 mg TID | Dyspepsia, gastroparesis | QT prolongation, arrhythmia, galactorrhea |
Metoclopramide | Dopamine receptor antagonist | 2.5–10 mg qAC and qHS | Dyspepsia, nausea, gastroparesis—good for acute, self-limited symptoms | QT prolongation, Eextrapyramidal symptoms, akathisia, galactorrhea |
Prucalopride | 5HT-4 Agonist | 2 mg QD | Constipation, dyspepsia, nausea | Abdominal pain, headache, diarrhea |
Neuromodulatory Agents | ||||
Buspirone | 5HT1-agonist | 15– 30 mg BID | Dyspepsia, nausea | Dizziness, vertigo, headache |
Mirtazapine | Antidepressant | 7.5–45 mg QD | Dyspepsia, nausea, increases appetite | Weight gain, drowsiness, dry mouth |
Olanzapine | Atypical antipsychotic | 2.5–10 mg QD | Dyspepsia, nausea, increases appetite | Weight gain, dyslipidemia, hyperglycemia, extrapyramidal symptoms, QT prolongation, sedation |
SNRI Duloxetine Venlafaxine | Serotonin and norepinephrine reuptake inhibitors | Duloxetine 30–90 mg QD Venlafaxine 75- 225 mg QD | Constipation, abdominal pain | Abdominal pain, decreased appetite, nausea, drowsiness |
SSRI Citalopram Escitalopram Fluoxetine Paroxetine Sertraline | Selective serotonin reuptake inhibitors | Citalopram 10–40 mg QD Escitalopram 5–20 mg QD Fluoxetine 10–40 mg QD Paroxetine 10–40 mg QD Sertraline 25–150 mg QD | Globus, dysphagia constipation, bloating | Nausea, diarrhea (less common with paroxetine), decreased libido |
Trazodone | Antidepressant, serotonin reuptake inhibitor/agonist | 75–150 mg QD | Globus, dysphagia, functional chest pain, insomnia | Nausea, dizziness, drowsiness, xerostomia, blurry vision |
Tricyclic Antidepressants Amitriptyline, Desipramine, Imipramine, Nortriptyline | Tricyclic antidepressant | 25–150 mg QD | Abdominal pain, dyspepsia, nausea | Drowsiness, dry mouth constipation, QT prolongation |
Quetiapine | Atypical antipsychotic | 25–200 qd | Abdominal pain | Weight gain, dyslipidemia, sedation |