Review for 10.1186/1471-230X-9-36 (2009)

Reviewer's report
Title:Antiulcer activity of fluvoxamine in rats and its effect on oxidant and
antioxidant parameters in stomach tissue
Version: 2Date:16 January 2009
Reviewer: gabriella coruzzi
Reviewer's report:
The paper by Dursun et al described the antiulcer effect of fluvoxamine in rats,
thus extending previous work made by the Authors in the same model with
another antidepressant, mirtazepine (in press, 2008). However, there are some
important issues to be clarified, before publication.
MAJOR COMPULSORY REVISIONS
The association between depression and other psychotic symptoms and gastric
ulcer is debatable. While it is well recognized that stress is a risk factor for gastric
damage, it is not completely assessed that depression is a causal factor,
therefore antidepressants could be used only as supportive therapy, together
with antiulcer drugs. However, the Authors seem to ignore that many reports in
the literature evidenced a correlation between the use of antidepressant (SSRI in
particular) and the risk of upper GI toxicity (Lewis JD et al., 2008; Ma J et al.,
2006; Yamaguchi T et al., 2008, to quote some). They quoted only two papers in
favour of a antiulcer activity of antidepressants.
Experimental protocol: The Authors used a total of 48 rats (6 rats per group).
It is not clear how the different groups were treated. This has not been clearly
described in Methods, Tables, Figures or Figure legends. In theory, based on the
aim of the study, rats should have been treated with indomethacin alone
(vehicle), or indomethacin plus 4 doses of fluvoxamine, fluvoxamine alone (4
doses), ranitidine alone (1 dose), ranitidine + indomethacin and finally intact rats
(no treatment at all). In total 12 groups and 72 rats. It can be deduced that the
Authors missed the groups with fluvoxamine or ranitidine alone. This is not
correct, especially on the light of the literature data showing that SSRI can induce
gastric damage and bleeding.
In addition it is highly surprising that the number of rats per group is so low;
gastric lesions induced by indomethacin are highly variable. The Authors should
report data with standard errors!
MINOR ESSENTIAL REVISIONS
ABSTRACT : Routes of administrations must be indicated.
Figures 7,8 and 9: it should be clearly indicated that fluvoxamine and ranitidine
were administered in the presence of indomethacin. It is presumable that the
word “control” applies to vehicle treated rat; this should be better indicated in the
figures and in Fig. legends
References: References are not properly quoted in the text. See, for example
Ref. 8, 10, 12, 26, 30, 42 and 43; many of these papers deal with intestine and
not stomach.
CONCLUSIONS
The antidepressant activity of fluvoxamine was not investigated in the present
paper, thus the sentence “we conclude that fluvoxamine has both antidepressant
and antiulcer effects” must be deleted or changed both in the abstract and in the
conlusions.
English must be extensively revised
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.