Name :

Andri

Current Position :
Department of Psychiatry, Faculty of Medicine, Krida Wacana
Christian University

Education :
- Medical Doctor – Universitas Indonesia
- Psychiatrist – Universitas Indonesia
TREATMENT OF FUNCTIONAL
GASTROINTESTINAL DISORDER :
PSYCHOSOMATIC APPROACH
ANDRI
DEPARTMENT OF PSYCHIATRY, FACULTY OF MEDICINE UKRIDA, JAKARTA

PSYCHOSOMATIC CLINIC OMNI HOSPITAL ALAM SUTERA, BANTEN

ILUSTRASI KASUS KLINIK (1)

• Perempuan usia 35 tahun sudah sekitar 1 tahun

belakangan ini mengeluh rasa tidak nyaman di
lambung, terutama di ulu hati, sering merasa
kembung. Pemeriksaan obyektif tidak menemukan
adanya kelainan. Endoskopi normal.
• Obat awal yang diberikan kepada pasien :
• Pariet 20mg 2x1
• Motilium 3x1
• Mucosta 2x1
(LANJUTAN KASUS)

• Kondisi belum membaik pasien lalu diberikan tambahan

racikan :
• Librax ½ tablet 
• Alprazolam 0.35 mg Obat diberikan pagi,
siang dan malam hari
• Sertraline 15mg 
• Serenace 0.5mg  

• Pasien mengalami perbaikan. Obat dilanjutkan sampai dua

bulan. Saat mau lepas obat, pasien mengalami sulit tidur.
• Pasien berobat untuk melepaskan ketergantungan akan obat
tersebut
ILUSTRASI KASUS KLINIK (2)

• Wanita muda usia 25 tahun dengan keluhan susah menahan

buang air besar jika berada dalam perjalanan di tol. 
• Hal ini membuatnya tidak ingin melakukan perjalanan
lewat tol padahal pekerjaannya sangat sering harus
bepergian bolak balik Tangerang-Jakarta
• Pasien merasakan kesulitan dalam pekerjaan dan ingin tidak
mengalami hal itu lagi. 
• Apa yang sejawat pikirkan?
ROME III Criteria
ROLE OF
PSYCHOPHARMACOTHERAP
Y IN FUNCTIONAL
DYSPEPSIA
IS THERE ANY SIGNIFICANT EFFECTS ?
META-ANALYSIS STUDY ABOUT
USING ANTIDEPRESSANTS FOR
FUNCTIONAL DYSPEPSIA
• 4 meta-analyses on this topic, all of which concluded
that antidepressants (TCA and SSRI) are effective in
relieving FD symptoms.
• Two studies included patients who were treated with
levosulpiride. Levosulpiride is a dopamine D2 receptor
antagonist and a mild 5-HT4 receptor agonist, which
make it both a prokinetic agent and an antidepressant
• One study concluded that only TCA not SSRI’s that was
useful for FD
Yaoyao Lu et al. Antidepressants in the Treatment of Functional Dyspepsia:
A Systematic Review and Meta-Analysis. PLOS One. Juni 2016
EFFECT OF AMITRIPTYLINE AND ESCITALOPRAM ON
FUNCTIONAL DYSPEPSIA : A MULTI-CENTER,
RANDOMIZED, CONTROLLED STUDY
Talley NJ, et al. Gastroenterology. 2015 August ; 149(2): 340–349
TREATMENT OF FUNCTIONAL DYSPEPSIA WITH ANTIANXIETY
OR ANTIDEPRESSIVE AGENTS : SYSTEMATIC REVIEW
JOURNAL OF GASTROENTEROLOGY
NOVEMBER 2005, VOLUME 40, ISSUE 11

• Thirteen articles, on 1717 patients, were selected from among 90 articles

• Antidepressants (amitryptiline, fluoxetine, clomipramine) were effective
to relieve the symptoms of FD (4 studies)
• Antianxiety (medazepam) were effective to relieve the symptoms of FD
(2 studies)
• Levosulpiride were effective to relieve the symptoms of FD (3 studies)
• AD and AA with combination anticholinergic agent, prokinetic, anti acid
secretory were helpful to relieve the symptoms of FD (one study)
EFFECTS ON GASTROINTESTINAL FUNCTIONS AND
SYMPTOMS OF SEROTONERGIC PSYCHOACTIVE AGENTS
USED IN FUNCTIONAL GASTROINTESTINAL DISEASES
GROVER M, CAMILLERI M
(J GASTROENTEROL (2013) 48:177–181)

• Buspirone, a prototype 5-HT1A agonist, enhances gastric

accommodation and reduces postprandial symptoms in
response to a challenge meal.
• Tricyclic antidepressants reduce sensations in response to
food, including nausea, and delay gastric emptying,
especially in females.
• Buspirone appears efficacious in functional dyspepsia
Gut 2005;54:1332–1341
Thank You