From the Research
Escitalopram may potentially cause duodenal gastritis in the bulb region, although the current evidence does not directly establish a causal relationship. The most recent and highest quality study, 1, evaluated the feasibility and safety of escitalopram in patients with functional gastrointestinal disorders, but it did not specifically investigate the incidence of duodenal bulb gastritis. However, it reported that 21.57% of patients experienced nausea/vomiting, which could be indicative of upper gastrointestinal symptoms. Other studies, such as 2, have investigated the clinicopathological features of duodenal bulb biopsies and their relationship with upper gastrointestinal diseases, but they did not examine the effects of escitalopram on the duodenal bulb. Given the potential for escitalopram to cause upper gastrointestinal symptoms, it is essential for patients taking escitalopram to consult their healthcare provider if they experience symptoms such as heartburn, nausea, or abdominal discomfort, which could indicate inflammation in the duodenal bulb. The healthcare provider may recommend taking the medication with food, adding a proton pump inhibitor for gastric protection, or considering an alternative antidepressant with fewer gastrointestinal effects. Some key points to consider:
- Escitalopram may increase gastric acid secretion and reduce protective mucus production in the gastrointestinal tract, leading to irritation of the duodenal lining.
- Patients taking escitalopram sometimes experience upper gastrointestinal symptoms, including heartburn, nausea, and abdominal discomfort.
- The mechanism involves serotonin's role in regulating both mood and gut function, as serotonin receptors are abundant throughout the digestive system, and altering serotonin levels can affect gastrointestinal motility and secretion.
- Studies have shown that escitalopram is generally well-tolerated, but it can cause gastrointestinal side effects, such as nausea and vomiting, in some patients 1, 3.