Prophylactic Gastric Histopathological Evaluation of Fluvoxamine and Mirtazapine in Aspirin Induced Rat Model

Abstract

Introduction: Depression is a mood disorder characterized by emotional dysregulation that causes distress in patients. It has strong association with peptic ulcer due to the underlying factor, stress, involved in its pathogenesis. The increased usage of NSAIDS and associated peptic ulcer disease (PUD) in depressive patients has raised concerns. Standard treatment is with PPIs like omeprazole Antiulcer effect of antidepressants fluvoxamine and mirtazapine was investigated in our previous research work by comparing the gastric glutathione and PGE2 levels in aspirin induced ulcer in rats.

Aims & Objectives: The current research aimed to comparatively evaluate the histopathological changes caused by fluvoxamine, mirtazapine vs omeprazole in gastric antral tissue by using aspirin.

Place and duration of study: A cross sectional analytical research of one month duration was conducted in Federal Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore.

Material & Methods: Five groups of Albino rats with each group comprising of ten animals, were used. Group A received aspirin only as a single dose of 400mg/kg via nasogastric tube. Groups B, C, D and E received through oral route prophylactically and in single dose omeprazole 20mg/kg, fluvoxamine 100mg/kg, fluvoxamine 200mg/kg and mirtazapine 60mg/kg respectively. Ulceration was induced with aspirin in groups B to E after forty five minutes. Four hours after administration of aspirin all the rat groups were killed by thiopentol 50mg/kg intraperitoneally. Antral ulcerated tissue was taken and kept in 10% formalin. Comparison was made for ulcers, necrosis, cellular infiltration, congestion.

Results: Upon sacrificing a histopathological analysis of gastric mucosa revealed that in group A (aspirin treated only) all animals had ulceration with necrosis, 70% were of severe nature while 80% had severe cellular infiltration and congestion. In comparison mild ulceration was noted in 70% of animals in Group C (fluvoxamine 100mg/kg), 20% in group E (mirtazapine 60mg/kg) and none in group B (omeprazole20mg/kg) and D (fluvoxamine 200mg/kg) and no necrosis. However all animals in groups B, C, D and E had mild cellular infiltration and congestion.

Conclusion: Rat gastric histological analysis revealed significant prophylactic gastroprotective ability of 200mg/kg fluvoxamine and lesser in 100mg/kg fluvoxamine and 60mg/kgmirtazapine versus 20mg/kg omeprazole in aspirin induced damage.