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Antidepressant Found To Alleviate Symptoms Of Irritable Bowel Syndrome In Adolescents

Date:
May 2, 2008
Source:
University of California - Los Angeles
Summary:
Low-dose antidepressant therapy can significantly improve the overall quality of life for adolescents suffering from irritable bowel syndrome, or IBS. The study is the first of its kind to look at the effects of amitriptyline, a tricyclic antidepressant, in the pediatric IBS population.

Researchers at Mattel Children's Hospital UCLA have found that low-dose antidepressant therapy can significantly improve the overall quality of lifefor 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.

Theresearch was conductedbetween 2002 and2005 and involved 33 newly diagnosed IBS patients, including 24girls, between the ages of 12 and 18.

Irritable bowel syndromecauses 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 studyconsisted ofthree phases: two weeks of enrollment and symptom scoring, eight weeks of therapy withamitriptyline or a placebo, and three weeks of post-medication "washout" and symptom scoring.

Patients were randomized in a double-blinded fashion to receivethe antidepressantor a placebo and were surveyed at two, six, 10 and 13 weeksusing 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 receivingamitriptyline were more likely to experience:

  • An improvement in overallquality of lifeat six, 10 and 13 weeks.
  • A reduction in IBS-associated diarrhea atsix and 10 weeks.
  • A reduction in pain near the belly button at 10 weeks.
  • A reduction inpain in the right lower quadrant of the abdomenat six, 10 and 13 weeks.

Baharsaid that more than halfofeligiblepatients, 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 andDrug 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.

The research was funded by James L. Brooks and the Diane Brooks Medical Research Foundation of the California Community Foundation, and by the pharmaceutical company AstraZeneca.

Other study authors included Dr. Brynie S. Collins, Dr. Barry Steinmetz and Dr. Marvin Ament.


Story Source:

The above story is based on materials provided by University of California - Los Angeles. Note: Materials may be edited for content and length.


Cite This Page:

University of California - Los Angeles. "Antidepressant Found To Alleviate Symptoms Of Irritable Bowel Syndrome In Adolescents." ScienceDaily. ScienceDaily, 2 May 2008. <www.sciencedaily.com/releases/2008/05/080501154222.htm>.
University of California - Los Angeles. (2008, May 2). Antidepressant Found To Alleviate Symptoms Of Irritable Bowel Syndrome In Adolescents. ScienceDaily. Retrieved September 17, 2014 from www.sciencedaily.com/releases/2008/05/080501154222.htm
University of California - Los Angeles. "Antidepressant Found To Alleviate Symptoms Of Irritable Bowel Syndrome In Adolescents." ScienceDaily. www.sciencedaily.com/releases/2008/05/080501154222.htm (accessed September 17, 2014).

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