Amitriptyline

Bryson, Harriet M.; Wilde, Michelle I.

doi:10.2165/00002512-199608060-00008

Cited by 185 publications

(30 citation statements)

References 79 publications

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“…This is consistent with studies showing amitriptyline is beneficial in pain syndromes including IBS and neuropathic pain. 9, 35 This differential treatment effect supports the division of FD into a pain or meal-related satiety subtype. Our findings complement the NORIG trial in which nortriptyline was not helpful in improving idiopathic gastroparesis symptoms including nausea, meal-related satiety, fullness, anorexia, and bloating.…”

Section: Discussionmentioning

confidence: 61%

Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study

et al. 2015

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Background & Aims Anti-depressants are frequently prescribed to treat functional dyspepsia (FD), a common disorder characterized by upper abdominal symptoms, including discomfort or post-prandial fullness. However, there is little evidence for the efficacy of these drugs in patients with FD. We performed a randomized, double-blind, placebo-controlled trial to evaluate the effects of anti-depressant therapy effects on symptoms, gastric emptying (GE), and mealinduced satiety in patients with FD. Methods We performed a study at 8 North American sites of patients who met the Rome II criteria for FD and did not have depression or use anti-depressants. Subjects (n=292; 44±15 y old, 75% female, 70% with dysmotility-like FD, and 30% with ulcer-like FD) were randomly assigned to groups given placebo, 50 mg amitriptyline, or 10 mg escitalopram for 10 weeks. The primary endpoint was adequate relief of FD symptoms for ≥5 weeks of the last 10 weeks (out of 12). Secondary endpoints included GE time, maximum tolerated volume in a nutrient drink test, and FD-related quality of life. Results An adequate relief response was reported by 39 subjects given placebo (40%), 51 given amitriptyline (53%), and 37 given escitalopram (38%) (P=.05, following treatment, adjusted for baseline balancing factors including all subjects). Subjects with ulcer-like FD given amitriptyline were more than 3-fold more likely to report adequate relief than those given placebo (odds ratio=3.1; 95% confidence interval, 1.1–9.0). Neither amitriptyline nor escitalopram appeared to affect GE or meal-induced satiety after the 10 week period in any group. Subjects with delayed GE were less likely to report adequate relief than subjects with normal GE (odds ratio=0.4; 95% confidence interval, 0.2–0.8). Both anti-depressants improved overall quality-of-life. Conclusions Amitriptyline, but not escitalopram, appears to benefit some patients with FD— particularly those with ulcer-like (painful) FD. Patients with delayed GE do not respond to these drugs.

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Section: Discussionmentioning

confidence: 61%

Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study

et al. 2015

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“…Amongst classes of drugs, substantial data suggest that tricyclic compounds are effective for treating most of the conditions noted (78-80). Newer serotoninnorepinephrine re-uptake inhibitors such as duloxetine and tramadol have similarly been shown to be effective across a broad range of these conditions (81), and interestingly duloxetine had much earlier been shown to be helpful in treating the pain associated with depression, which is not surprising.…”

Section: Similar Treatments Work For Many Of the Css Entitiesmentioning

confidence: 99%

Central pain mechanisms in chronic pain states – Maybe it is all in their head

Phillips

Clauw

2011

Best Practice & Research Clinical Rheumatology

285

254

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Mechanisms underlying chronic pain differ from those underlying acute pain. In chronic pain states, central nervous system (CNS) factors appear to play particularly prominent roles. In the absence of anatomical causes of persistent pain, medical sub-specialties have historically applied wide-ranging labels (e.g. fibromyalgia -FM, irritable bowel syndrome, interstitial cystitis, somatization) for what now is emerging as a single common set of CNS processes. The hallmark of these “centrally-driven” pain conditions is a diffuse hyperalgesic state identifiable using experimental sensory testing, and corroborated by functional neuroimaging. The characteristic symptoms of these central pain conditions include multifocal pain, fatigue, insomnia, memory difficulties, and a higher rate of co-morbid mood disorders. In contrast to acute and “peripheral” pain states that are responsive to NSAIDs and opioids, central pain conditions respond best to CNS neuromodulating agents such as serotonin-norepinephrine re-uptake inhibitors (SNRIs) and anticonvulsants.

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“…In treating depression amitryptiline diplays also a sedation sideeffect (Bryson & Wilde, 1996). In humans, this medication is used in the treatment of anxiety, bipolar disorders and depression.…”

Section: Commentmentioning

confidence: 99%