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Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome.

Abstract

BACKGROUND

Irritable bowel syndrome is the most common disorder diagnosed by gastroenterologists. Although several randomized-controlled trials have assessed the therapeutic role of antidepressant drugs, there is insufficient evidence to support their use.

AIM

To compare the effects of low-dose amitriptyline in the treatment of diarrhoea-predominant irritable bowel syndrome in a double-blind randomized-controlled trial.

METHODS

Fifty-four patients who fulfilled Rome II criteria for diarrhoea-predominant irritable bowel syndrome were included in this study. Organic causes were ruled out by standard laboratory and radiological tests, and rectosigmoidoscopy. Patients were randomly assigned to receive either 10 mg amitriptyline daily or placebo. Subjects were followed up for 2 months and symptoms were assessed using a questionnaire. Intention-to-treat and per-protocol analysis was performed.

RESULTS

Fifty patients completed the study. At 2 months, the amitriptyline group showed greater (P < 0.05) reduction in the incidence of loose stool and feeling of incomplete defecation. Patients receiving amitriptyline showed greater complete response, defined as loss of all symptoms, compared with those receiving placebo (68% vs. 28%, P = 0.01). Adverse effects were similar between the two groups.

CONCLUSION

Amitriptyline may be effective in the treatment of diarrhoea-predominant irritable bowel syndrome and at low dose is well tolerated.

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  • Authors+Show Affiliations

    ,

    Digestive Disease Research Center, Shariati Hospital, Medical Sciences/University of Tehran, Tehran, Iran. vahedi@ams.ac.ir

    , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Amitriptyline
    Analgesics, Non-Narcotic
    Diarrhea
    Double-Blind Method
    Female
    Gastrointestinal Agents
    Humans
    Irritable Bowel Syndrome
    Male
    Middle Aged
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18248658

    Citation

    Vahedi, H, et al. "Clinical Trial: the Effect of Amitriptyline in Patients With Diarrhoea-predominant Irritable Bowel Syndrome." Alimentary Pharmacology & Therapeutics, vol. 27, no. 8, 2008, pp. 678-84.
    Vahedi H, Merat S, Momtahen S, et al. Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2008;27(8):678-84.
    Vahedi, H., Merat, S., Momtahen, S., Kazzazi, A. S., Ghaffari, N., Olfati, G., & Malekzadeh, R. (2008). Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 27(8), pp. 678-84. doi:10.1111/j.1365-2036.2008.03633.x.
    Vahedi H, et al. Clinical Trial: the Effect of Amitriptyline in Patients With Diarrhoea-predominant Irritable Bowel Syndrome. Aliment Pharmacol Ther. 2008;27(8):678-84. PubMed PMID: 18248658.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. AU - Vahedi,H, AU - Merat,S, AU - Momtahen,S, AU - Kazzazi,A S, AU - Ghaffari,N, AU - Olfati,G, AU - Malekzadeh,R, Y1 - 2008/01/30/ PY - 2008/2/6/pubmed PY - 2008/5/3/medline PY - 2008/2/6/entrez SP - 678 EP - 84 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 27 IS - 8 N2 - BACKGROUND: Irritable bowel syndrome is the most common disorder diagnosed by gastroenterologists. Although several randomized-controlled trials have assessed the therapeutic role of antidepressant drugs, there is insufficient evidence to support their use. AIM: To compare the effects of low-dose amitriptyline in the treatment of diarrhoea-predominant irritable bowel syndrome in a double-blind randomized-controlled trial. METHODS: Fifty-four patients who fulfilled Rome II criteria for diarrhoea-predominant irritable bowel syndrome were included in this study. Organic causes were ruled out by standard laboratory and radiological tests, and rectosigmoidoscopy. Patients were randomly assigned to receive either 10 mg amitriptyline daily or placebo. Subjects were followed up for 2 months and symptoms were assessed using a questionnaire. Intention-to-treat and per-protocol analysis was performed. RESULTS: Fifty patients completed the study. At 2 months, the amitriptyline group showed greater (P < 0.05) reduction in the incidence of loose stool and feeling of incomplete defecation. Patients receiving amitriptyline showed greater complete response, defined as loss of all symptoms, compared with those receiving placebo (68% vs. 28%, P = 0.01). Adverse effects were similar between the two groups. CONCLUSION: Amitriptyline may be effective in the treatment of diarrhoea-predominant irritable bowel syndrome and at low dose is well tolerated. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/18248658/Clinical_trial:_the_effect_of_amitriptyline_in_patients_with_diarrhoea_predominant_irritable_bowel_syndrome_ L2 - https://doi.org/10.1111/j.1365-2036.2008.03633.x DB - PRIME DP - Unbound Medicine ER -