Double-blind Placebo-Controlled Trial of Amitriptyline for the Treatment of Irritable Bowel Syndrome in Adolescents

Objectives

To determine the efficacy of amitriptyline (AMI) in treating irritable bowel syndrome (IBS) in adolescents.

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.

Abbreviations: AMI, Amitriptyline, FGID, Functional gastrointestinal disorder, IBS, Irritable bowel syndrome, PRS, Pain-rating scale, QOL, Quality of life, SSRI, Selective serotonin reuptake inhibitors, TCA, Tricyclic antidepressant