Antidepressant found to alleviate symptoms of irritable bowel syndrome in adolescents

May 01, 2008

Researchers at Mattel Children's Hospital UCLA have found that low-dose antidepressant therapy can significantly improve the overall quality of life for adolescents suffering from irritable bowel syndrome, or IBS.

The syndrome affects 6 percent of middle school students and 14 percent of high school kids in the United States.

The study, published in the May issue of the peer-reviewed Journal of Pediatrics, is the first of its kind to look at the effects of amitriptyline, a tricyclic antidepressant, in the pediatric IBS population, researchers said.

The research was conducted between 2002 and 2005 and involved 33 newly diagnosed IBS patients, including 24 girls, between the ages of 12 and 18.

Irritable bowel syndrome causes discomfort in the abdomen, along with diarrhea, constipation or both. Currently, there is no cure, and treatments only lessen the symptoms.

"While research has shown that amitriptyline is effective for adults with IBS, only peppermint oil has been studied in children with this disorder in a double-blind, placebo-controlled fashion," said Dr. Ron J. Bahar, assistant clinical professor of pediatric gastroenterology at Mattel Children's Hospital UCLA and lead author of the study. "Our results show that amitriptyline significantly improves overall quality-of-life measurements in adolescents and should be a therapeutic option for these patients. We were actually surprised to reach our conclusion with a relatively small number of subjects."

The 13-week study consisted of three phases: two weeks of enrollment and symptom scoring, eight weeks of therapy with amitriptyline or a placebo, and three weeks of post-medication "washout" and symptom scoring.

Patients were randomized in a double-blinded fashion to receive the antidepressant or a placebo and were surveyed at two, six, 10 and 13 weeks using a symptom checklist, a pain-rating scale, a pain intensity and frequency scale, and an IBS quality-of-life questionnaire.

The results showed that patients receiving amitriptyline were more likely to experience:
-- An improvement in overall quality of life at six, 10 and 13 weeks.
-- A reduction in IBS-associated diarrhea at six and 10 weeks.
-- A reduction in pain near the belly button at 10 weeks.
-- A reduction in pain in the right lower quadrant of the abdomen at six, 10 and 13 weeks.

Bahar said that more than half of eligible patients, or their parents or guardians, refused to enroll in the study because they were uncomfortable with using an antidepressant medication of any kind, citing negative reports in the media about their side effects and the Food and Drug Administration's formal 2004 "black box" warnings regarding the increased potential for suicide in children using antidepressants.

"However, the dose of AMI (amitriptyline) used in this study, as well as IBS treatment for adults, is far less than the dose to treat depression," Bahar said. "At these low levels, it could be considered a remedy to treat neuropathic pain associated with chronic pain symptoms, rather than an antidepressant or psychotropic medication."

The next stage of research will look at the long-term follow-up of these patients to determine who will continue to stay well on the medication, whose symptoms resolve spontaneously and what other medications can be used as an alternative to amitriptyline for adolescents with IBS.

Source: University of California - Los Angeles

Explore further: New treatment approved for rare form of hemophilia

add to favorites email to friend print save as pdf

Related Stories

Newer Antidepressants Not Always Better

May 06, 2009

Old standby Zoloft? Late-model Lexapro? New antidepressants might be no more effective than the best existing drugs, according to two new systematic reviews that compared 12 commonly used medications.

Recommended for you

WHO: Millions of Ebola vaccine doses ready in 2015

Oct 24, 2014

The World Health Organization says millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines will start being tested in March.

Added benefit of vedolizumab is not proven

Oct 23, 2014

Vedolizumab (trade name Entyvio) has been approved since May 2014 for patients with moderately to severely active Crohn disease or ulcerative colitis. In an early benefit assessment pursuant to the Act on the Reform of the ...

Seaweed menace may yield new medicines

Oct 22, 2014

An invasive seaweed clogging up British coasts could be a blessing in disguise. University of Greenwich scientists have won a cash award to turn it into valuable compounds which can lead to new, life-saving drugs.

User comments : 0