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Drugs that Work in the Brain

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Pediatric Neurogastroenterology

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Abstract

Our adult colleagues have shown convincingly that a number of psychotropic drugs are effective in managing symptoms of functional gastrointestinal disorders. Many pediatric gastroenterologists justify treating pediatric patients with psychotropic drugs based on results from adult studies and on accruing personal experience. This chapter cites the most important adult studies, the handful of pediatric studies, and the authors’ personal experience. Amitriptyline is the most commonly used psychotropic drug: it treats irritable bowel syndrome, functional dyspepsia, functional abdominal pain not otherwise specified, cyclic vomiting syndrome, and abdominal migraine prophylaxis, and less commonly for functional diarrhea and the incontinence that often follows successful Hirschsprung’s disease surgery. Other psychotropic drugs less commonly used for treating gastrointestinal symptoms or psychiatric conditions associated with functional disorders include mirtazapine, the serotonin reuptake inhibitors, clonidine, gabapentin, and benzodiazepines. The prescribing clinician is obligated to educate the patient and family about the rationale, benefits, and risks of each drug, and to answer the questions posed by the patient and parents. Taking the time to listen and patiently answer concerns is essential to developing the therapeutic alliance between clinician and family that will optimize treatment adherence.

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Authors and Affiliations

  1. Division of Gastroenterology, Children’s Hospital, Louisiana State University, New Orleans, LA, USA

    Paul E. Hyman M.D. & Rami Arrouk M.D.

Authors
  1. Paul E. Hyman M.D.
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  2. Rami Arrouk M.D.
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Correspondence to Paul E. Hyman M.D. .

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Editors and Affiliations

  1. Division of Pediatric Gastroenterology Hepatology and Nutrition, CHU Sainte-Justine, Montreal, Québec, Canada

    Christophe Faure

  2. Department of Paediatric Gastroenterology, UCL Institute of Child Health, London, United Kingdom

    Nikhil Thapar

  3. Division of Pediatric Gastroenterology Hepatology, and Nutrition, Nationwide Children’s Hospital, Columbus, Ohio, USA

    Carlo Di Lorenzo

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Hyman, P.E., Arrouk, R. (2017). Drugs that Work in the Brain. In: Faure, C., Thapar, N., Di Lorenzo, C. (eds) Pediatric Neurogastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-43268-7_45

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  • DOI: https://doi.org/10.1007/978-3-319-43268-7_45

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43266-3

  • Online ISBN: 978-3-319-43268-7

  • eBook Packages: MedicineMedicine (R0)

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