Antidepressant may calm teens' irritable bowels

NEW YORK (Reuters Health) - Treatment with the antidepressant amitriptyline can reduce symptoms and improve quality of life in adolescents with irritable bowel syndrome (known as IBS), the results of a small study suggest.

People with IBS suffer chronic discomfort with cramping, diarrhea or constipation. The causes of IBS are unclear and there has been debate whether it is mostly due to psychological factors or biological triggers, or perhaps a combination.

"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," Dr. Ron J. Bahar, from the University of California at Los Angeles, said in a statement.

As reported in The Journal of Pediatrics, Bahar and colleagues assessed the outcomes of 33 patients who were randomized to receive amitriptyline or placebo. The study subjects were between 12 and 18 years of age and included 24 females. The 13-week study consisted of a 2-week symptom scoring phase, followed by 8 weeks of treatment, and then a 3-week washout phase.

Compared with teens taking placebo, those taking amitriptyline were more likely to show improvements in quality of life during the study.

Amitriptyline therapy was also associated with significant reductions in IBS-related diarrhea and pain.

According to Bahar, the study group was limited in size because the parents and guardians of many eligible patients declined participation out of concern over recent reports linking antidepressant use in children with suicide. However, he emphasized, the dose of amitriptyline used in the present study is well below that typically used to treat depression.

"Given the findings of our study, future investigations should appropriately focus on the judicious use of amitriptyline and other chronic pain medications in children with functional gastrointestinal disorders to complement biopsychosocial and antibiotic therapy in these patients," the researchers state.

SOURCE: The Journal of Pediatrics, May 2008.