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

Bahar, Ron J. MD
Collins, Brynie S. MD
Steinmetz, Barry MD
Ament, Marvin E. MD

^a Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, UCLA Geffen School of Medicine, Los Angeles, CA
^b Children's Hospital Los Angeles, Keck-USC School of Medicine, Los Angeles, CA.

^* Reprint requests: Ron Bahar, MD, UCLA Geffen School of Medicine, 5363 Balboa Blvd, Suite 540, Encino, CA 91316. E-mail: [email protected].

Supported by James L. Brooks and the Diane Brooks Medical Research Foundation of the California Community Foundation (Los Angeles, CA), as well as by AstraZeneca, LP (Wayne, PA).

Submitted for publication Jun 1, 2007; lastrevision received Sept 27, 2007; accepted Oct 15, 2007

Journal of Pediatrics 152(5):p 685-689, May 2008.

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.