This is the Medscape Medical Minute. I'm Dr. George Lundberg.
Seven gastroenterology investigators in Iran tested the effect of low-dose, 10 mg daily, of amitriptyline in 54 patients with diarrhea-predominant irritable bowel syndrome in a double-blind, randomized, placebo-controlled trial. Organic causes had been ruled out. Fifty patients completed the intention-to-treat study that was reported in the journal Alimentary Pharmacology & Therapeutics in 2008.[1] Sixty-eight percent of those receiving amitriptyline had a “complete response,” defined as loss of all symptoms over a 2-month trial period, compared to only 28% of the controls. Small total study size; common clinical problem; big differences in response. Might be worth trying clinically.
This article is selected from Medscape Best Evidence.[2] I'm Dr. George Lundberg.
Footnotes
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References
- 1.Vahedi H, Merat S, Momtahan S, et al. Clinical trial: the effect of amitriptyline in patients with diarrhoea-prodominant irritable bowel syndrome. Aliment Pharmacol Ther. 2008;27:678–684. doi: 10.1111/j.1365-2036.2008.03633.x. [DOI] [PubMed] [Google Scholar]
- 2.Family Medicine/Primary Care in Medscape Best Evidence, powered by McMaster Plus. Available at: http://www.medscape.com/pages/features/newsletters/bestevidence/fmpc Accessed May 27, 2008.