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Amitriptyline improves functional dyspepsia symptoms

03 Mar 2018

Antidepressants, particularly amitriptyline, appear to be effective in improving functional dyspepsia (FD) symptoms but not in delaying gastric emptying, a recent study has shown.

Researchers randomized 292 FD patients to receive 50 mg of amitriptyline (AMI), 10 mg of escitalopram (ESC) or matching placebo over a 12-week trial period. Majority of patients (53 percent) who received AMI showed global improvements in FD symptoms, as opposed to only 38 percent in the ESC and 50 percent in the placebo groups. The among-difference was of borderline significance (p=0.054).

While none of the treatment groups had a significant impact on maximal-tolerated volume in the nutrient drink test (MTV), aggregate symptom scores, which included abdominal pain, fullness and bloating, were significantly better in both the AMI and ESC group relative to placebo (p=0.04).

In terms of individual symptoms, antidepressant therapy significantly improved both bloating 30 minutes after nutrient drink test (p=0.04) and abdominal pain (p=0.09) relative to placebo. Amitriptyline was significantly better than escitalopram for abdominal pain.

Antidepressant therapy also significantly increased postprandial gastric volume (p=0.02), and the effect remained significant even when restricted to AMI (p<0.01) or ESC (p=0.05) groups only, as compared with the placebo group. AMI and ESC were statistically comparable in terms of postprandial gastric volume (p=0.37). Fasting gastric volume was unaffected by antidepressant therapy (p=0.66).

Baseline delayed gastric emptying was reported in 21 percent of the participants. None of the treatments resulted in significantly altered gastric emptying.

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