par De Buck, René
Référence Acta gastro-enterologica Belgica (Ed. multilingue), 44, 9-10, page (417-423)
Publication Publié, 1981
Article révisé par les pairs
Résumé : The psychotropic drugs responsible for side effects on the gastrointestinal tract are essentially those that develop the most effective anticholinergic actions. But also to be taken into account are the depression of the central nervous system, the alpha adrenergic effects and the indirect results of the relief of the anxiety and depression symptoms. In spite of the anti-emetic properties of the antipsychotic drugs, nauseas and vomiting appear as frequently as with placebos. The antipsychotic and antidepressive drugs provoke dysphagia and achalasia, because of a loss of tonus. Some cases of hiatal hernia are attributed to tricyclic antidepressants. The latter drugs, as well as IMOA and aliphatic and piperidinated phenothiazines, induce constipation in psychiatric patients, who are already prone to it. Even ileus may occur, or dilatation of the bowel or the stomach. Diarrhea is rare. Patients treated with psychotropics often complain of a dry mouth (xerostomy). This unpleasant sensation is succesfully treated with betanechol (75 mg/d) which does not impair - as pilocarpine does - the therapeutic effects. Dental caries, moniliasis and parotidites have been attributed to neuroleptic drugs or tricyclic antidepressants, on account of the inhibition of the salivary flow. Vomiting, diarrhea and epigastric burning appear in 10% of the patients treated with lithium (even when the posology is correct).