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 23 June 2018

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News

Amitriptyline improves sleep in functional dyspepsia

March's issue of Clinical Gastroenterology and Hepatology identifies effects of amitriptyline and escitalopram on sleep and mood in patients with functional dyspepsia.

News image

Tricyclic antidepressants are effective in reducing symptoms of functional dyspepsia.

Professor Nicholas Talley and colleagues from Australia performed a post hoc analysis of data from a previous randomized clinical trial to determine whether the benefits of an antidepressant on gastrointestinal symptoms in patients with functional dyspepsia were mediated by improving sleep or reducing anxiety.

The team of researchers explored the relationships between psychological measures, quality of sleep, and relief of symptoms.

The team analyzed data from a multicenter, double-blind trial that evaluated the efficacy of antidepressants on symptoms of functional dyspepsia from 2006 through 2012.

Patients were randomly assigned to groups given 50 mg amitriptyline, 10 mg escitalopram, or placebo for 12 weeks.

Responders had decreased anxiety and improvements in some sleep components
Clinical Gastroenterology and Hepatology

During the study, participants completed the following validated psychological questionnaires: Symptom Check List 90, Symptom Somatic Checklist, Hospital Anxiety Depression Scale, Profile of Mood States, State Trait Anxiety Inventory, and Pittsburgh Sleep Quality Index at baseline and 12 weeks following treatment.

Baseline scores for the psychological and sleep measures were similar among groups.


The team found that after 12 weeks there were no significant differences in scores among groups.

Baseline mean global Pittsburgh Sleep Quality Index scores indicated poor sleep quality in all groups at baseline and after 12 weeks.

Overall, the researchers noted that antidepressants affected sleep duration scores: patients given amitriptyline had lower scores than patients given placebo or escitalopram.

In all groups, responders had decreased anxiety and improvements in some sleep components.

Professor Talley's colleagues concluded, "In a post hoc analysis of data from a clinical trial that evaluated the effects of antidepressants in patients with functional dyspepsia, amitriptyline was found to reduce symptoms of functional dyspepsia, but its mechanism is unlikely to involve reductions in psychological distress."

"The drug may modestly improve sleep."

Clin Gastroenterol Hepatol 2018:16(3): 401-406 e2
28 March 2018

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