{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:31:21Z","timestamp":1753878681918,"version":"3.41.2"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In placebo\u2010controlled clinical trials, reboxetine, a selective noradrenaline reuptake inhibitor, increases urethral pressure and relieves stress urinary incontinence symptoms in women. Considering the close connection in neural regulation of the external urethral and anal sphincters, we hypothesized that reboxetine may also enhance anal sphincter pressure. Conversely, it is believed that selective serotonin reuptake inhibitors may contribute to fecal incontinence by reducing anal sphincter pressure. In this study, we investigated the effect of reboxetine and citalopram on anal opening pressure in healthy female volunteers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a double\u2010blind, three\u2010way crossover trial, 24 female participants received single doses of 40\u2009mg citalopram, 8\u2009mg reboxetine, and matching placebos, with a minimum of 8\u2010day washout between sessions. Using anal acoustic reflectometry, we measured anal opening pressure during both resting and squeezing conditions at the estimated time of peak plasma concentration for both study drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Compared with placebo, reboxetine increased anal opening pressure with 23.4\u2009cmH<jats:sub>2<\/jats:sub>O (95% confidence interval [CI] 16.5\u201330.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) during rest and with 22.5 cmH<jats:sub>2<\/jats:sub>O (95% CI 15.2\u201329.8, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) during squeeze. Citalopram did not change anal opening pressure statistically significantly compared to placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>An 8\u2010mg dose of reboxetine increased anal opening pressure substantially in healthy women, suggesting potential benefits for fecal incontinence symptoms. In contrast, a 40\u2010mg dose of citalopram showed a marginal and statistically insignificant effect on anal opening pressure, indicating that selective serotonin reuptake inhibitors do not contribute to fecal incontinence by reducing anal sphincter tone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14882","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T09:19:06Z","timestamp":1722331146000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of reboxetine and citalopram on anal opening pressure in healthy women: A randomized, double\u2010blind, placebo\u2010controlled crossover study"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-2707","authenticated-orcid":false,"given":"Thea","family":"Christoffersen","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Troels","family":"Riis","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesper","family":"Sonne","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonatan","family":"Kornholt","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"Sonne","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels","family":"Klarskov","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Gynecology and Obstetrics Copenhagen University Hospital \u2013 Herlev and Gentofte  Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"volume-title":"Incontinence 7th Edition","year":"2023","author":"Cardozo L","key":"e_1_2_11_2_1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.07.018"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.04.054"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.11.1311"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.009"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31823b2499"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12213"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.2000.01306.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.06.035"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2011.02728.x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236848"},{"issue":"3","key":"e_1_2_11_13_1","first-page":"311","article-title":"Usefulness of valproate sodium for treatment of incontinence after ileoanal anastomosis","volume":"107","author":"Kusunoki M","year":"1990","journal-title":"Surgery"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.01.114"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(08)61675-4"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23282"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00111.2010"},{"key":"e_1_2_11_18_1","unstructured":"National Institute for Health and Clinical Excellence.Faecal incontinence: the management of faecal incontinence in adults NICE. 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