Effectiveness of amitriptyline for treating functional dyspepsia in adolescents

Main Article Content

Indra Mustawa
Supriatmo Supriatmo
Hakimi Hakimi
Atan Baas Sinuhaji

Abstract

Background Functional dyspepsia is common among adolescents. Pain reduces children’s quality of life, psychosocial functioning, and school attendance. Amitriptyline is assumed to be one of the alternative treatments in functional dyspepsia.

Objective To investigate the effectiveness of amytriptyline as a treatment  for  functional dyspepsia in adolescents.

Methods We conducted a randomized, single-blind, controlled trial from January to March 2011 in junior and senior high school students in Dobo City, Aru Island District, Maluku Province. Adolescents suffering from functional dyspepsia and who fulfilled the inclusion criteria were eligible for the study. Subjects were randomized into two groups. Each group received 10 mg (for body weight < 35 kg) or 20 mg (for body weight ≥ 35 kg) amitriptyline or placebo once per day for 28 days. Pain frequency was measured in terms of abdominal pain episodes per month, and duration was measured in minutes. Data were analyzed using t-test.

Results Eighty-eight students participated in this study: the amitriptyline group (43 subjects) and the placebo group (45 subjects). There were no statistically significant differences between the amitriptyline and placebo groups in frequency (P=0.777; 95%CI -0.846 to 1.129) or duration (P=0.728) of abdominal pain after treatment.

Conclusion  Amitriptyline is not more effective than placebo for treating functional dyspepsia in adolescents. 

 

Article Details

How to Cite
1.
Mustawa I, Supriatmo S, Hakimi H, Sinuhaji A. Effectiveness of amitriptyline for treating functional dyspepsia in adolescents. PI [Internet]. 9Jan.2017 [cited 19Jul.2019];56(5):262-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/973
Section
Articles
Received 2016-10-19
Accepted 2016-10-19
Published 2017-01-09

References

1. Saps M, Youssef N, Miranda A, Nurko S, Hyman P, Cocjin J, et al. Multicenter, randomized, placebo–controlled trial of amitriptyline in children with functional gastrointestinal disorders. Gastroenterology. 2009;137:1261–9.
2. Torpy JM, Lynm C, Glass RM. Dyspepsia. JAMA. 2006;295:1612.
3. Youssef NN, Murphy TG, Langseder AL, Rosh JR. Quality of life for children with functional abdominal pain: a comparison study of patients’ and parents’ perceptions. Pediatrics. 2006;117:54-9.
4. Wilhelmsen I. Somatization, sensitization, and functional dyspepsia. Scand J Psychol. 2002;43:177–80.
5. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130:1527-37.
6. Allescher HD. Functional dyspepsia–a multicausal disease and its therapy. Phytomedicine. 2006;13:2–11.
7. Olden KW. The use of antidepressants in functional gastrointestinal disorders: new uses for old drugs. CNS Spectr. 2005;10:891-6.
8. Drossman DA. Rome III: the new criteria. Chin J Dig Dis. 2006;7:181-5.
9. Kalantar JS, Talley NJ. Towards a diagnosis of functional dyspepsia. Medicine Today. 2007;8:45-50.
10. Chitkara DK, Delgado-Aros S, Bredenoord AJ, Cremonini F, El-Youssef M, Freese D, et al. Functional dyspepsia, upper gastrointestinal symptoms, and transit in children. J Pediatr. 2003;143:609-13.
11. Reshetnikov OV, Kurilovich SA, Denisova DV, Zavylova LG, Tereshonok IN. Prevalence of dyspepsia and irritable bowel syndrome among adolescents of Novosibirsk, western Siberia. Int J Circumpolar Health. 2001;60:253-7.
12. Boey CC, Yap SB. An epidemiological survey of recurrent abdominal pain in a rural Malay school. J Paediatr Child Health. 2000;36:114-6.
13. Saps M, Di Lorenzo C. Pharmacotherapy for functional gastrointestinal disorders in children. J Pediatr Gastroenterol Nutr. 2009;48:101–3.
14. Thiwan SI, Drossman DA. Treatment of functional GI disorders with psychotropic medicines: a review of evidence with a practical approach. J Gastroenterol & Hepatol. 2006;2:678–87.
15. Talley NJ, Vakil N. Guidelines for the management of dyspepsia. Am J Gastroenterol. 2005;100:2324-37.
16. Monkemuller A, Malfertheiner P. Drug treatment of functional dyspepsia. World J Gastroenterol. 2006;12:2694-700.
17. Parkman HP. Motility and functional disorders of the stomach: diagnosis and management of functional dyspepsia and gastroparesis. Practical Gastroenterol. 2006:23–48.
18. Vase L, Robinson ME, Verne GN, Price DD. Increased placebo analgesia over time in irritable bowel syndrome (IBS) patients is associated with desire and expectation but not endogenous opioid mechanisms. Pain. 2005;115:338–47.
19. Fernandes R, Ferreira JJ, Sampaio C. The placebo response in studies of acute migraine. J Pediatr. 2008;152:527–33.
20. Bahar RJ, Collins BS, Steinmetz B, Ament ME. Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents. J Pediatr. 2008;152:685-9.
21. Otaka M, Jin M, Odashima M, Matsuhashi T, Wada I, Horikawa Y, et al. New strategy of therapy for functional dyspepsia using famotidin mosapride and amitriptyline. Aliment Pharmacol Ther. 2005;21:42–6.
22. Patel SM, Stason WB, Legedza A, Ock SM, Kaptchuk TJ, Conboy L, et al. The placebo effect in irritable bowel syndrome trials: a meta-analysis. Neurogastroenterol Motil. 2005;17:332–40.
23. Bridge JA, Birmaher B, Iyengar S, Barbe RP, Brent DA. Placebo response in randomized controlled trials of antidepressants for pediatric major depressive disorder. Am J Psychiatry. 2009;166:42–9.