To determine the efficacy of amitriptyline (AMI) in treating irritable bowel syndrome (IBS) in adolescents. [Note: Amitriptyline is a tricyclic antidepressant that supports higher levels of the neurotransmitters serotonin, norepinephrine, and dopamine. It is sometimes used for chronic pain, eating disorders and certain skin problems, and carries a "black box" warning for patients under age 18
Study design: Adolescents 12 to 18 years with newly diagnosed IBS were surveyed with a symptom checklist, pain rating scale, visual analog scale, and IBS quality of life (QOL) questionnaire. Subjects were randomized in a double-blinded fashion to receive AMI or placebo, and again completed surveys at 2, 6, 10, and 13 weeks.
Results: Thirty-three patients (24 female) were enrolled. Patients receiving AMI were more likely to experience improvement from baseline in overall QOL at 6, 10, and 13 weeks (P = .019, .004, and .013). Patients receiving AMI were also more likely to experience:
- A reduction in IBS-associated diarrhea at 6 and 10 weeks (P = .029 for both),
- A reduction in periumbilical pain at 10 weeks (P = .018), and
- A reduction in right lower quadrant pain at 6, 10, and 13 weeks (P = .014, .039, and .004).
Conclusion: AMI significantly improves overall QOL in adolescents with IBS and should be a therapeutic option for adolescents with this disorder.
[Note: For more information, see "Antidepressant found to alleviate symptoms of Irritable Bowel Syndrome in adolescents."]
Source: Journal of Pediatrics. May 2008. 152(5); pp. 685-689. PMID: 18410774, by Bahar RJ, Collins BS, Steinmetz B, Ament ME. Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, UCLA Geffen School of Medicine; Children's Hospital Los Angeles, Keck-USC School of Medicine, Los Angeles, CA. [E-mail: email@example.com]