Micturition and the soul II -- antidepressants against CPPS ?

Mood disorders and pelvic disorders are commonly comorbid and antidepressants are effective treatments of nocturia and bowel disorders. Thus suggesting “a common, or at least overlapping, pathophysiology at a level where the functions of the different pelvic viscera are integrated” e.g.viscerosensory nerves, vagus nerve, the lumbosacral spinal cord and the pons (more specifically the locus coeruleus, Barrington’s nucleus, vagus nerve termini). (1,2) (Regarding the use of anti-depressants and cytokine-suppressants, e.g. etanercept, a TNF-alpha inhibitor, for CPPS, some studies have been done, but I have not found any information about what the results where. May I assume no success or too much side effects?)

Murine studies show “diffuse overlap within the brain stem and spinal cord of autonomic innervation to peripheral tissues” indicating a possible cause of referred pain from the bladder/pelvis and that “ongoing pathology” from a “dysfunctional lower urinary tract may cause symptoms and functional changes in distinct peripheral regions of the body” and that “flooding of these neuronal circuitries with noxious information from one peripheral organ may also cause changes within the system and other organs”.(3)

Experiments also indicate that even short time bladder obstruction / dysfunction may lead to neurobehavioural effects like hyper-arousal, sleep changes, anxiety, attention disorders and “disruption of sensorimotor integration”. (4) Question is if these disturbances are directly caused by the underlying cause of the bladder dysfunction, or as a consequence of the sleep disruption or some other factor. (Also see Micturition and the soul part I.)

Interestingly enough the same pathways are sensitized by chronic cold exposure, which may explain why cold worsens CPPS symptoms.(5) About which I'll talk inte next installment.

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, nokturi, överaktiv blåsa, anti-depressiva medel, köld, etanercept, neurologiska besvär.
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(1) Valentino RJ, Miselis RR, Pavcovich LA. Pontine regulation of pelvic viscera: pharmacological target for pelvic visceral dysfunctions. Trends Pharmacol Sci 20:253-260, 1999.
(2) Goehler LE, Lyte M, Gaykema RPA. Infection-induced viscerosensory signals from the gut enhance anxiety: implications for psychoneurimmunology. Brain Behav Immun 21:721-726, 2007.
(3) Zermann DH, Ishigooka M, Schubert J, Schmidt RA. Is there a relationship between chronic bladder dysfunction and somatic symptoms in other body regions? 2. An experimental neuroanatomical approach. Int Urol Nephrol 37:263-273, 2005.
(4) Rickenbacher E, Baez MA, Hale L, Leiser SC, Zderic SA, Valentino RJ. Impact of overactive bladder on the brain: central sequelae of a visceral pathology. PNAS 105(30):10589-10594, 2008.
(5) Jedema H, Finlay JM, Sved AF, Grace AA. Chronic cold exposure potentiates CRH-evoked increases in electrophysiologic activity of locu coeruleus neurons.