However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made .
Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition .
Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study.
BACKGROUND & AIMS Antidepressants are frequently prescribed to treat functional dyspepsia ( FD ) , a common disorder characterized by upper abdominal symptoms , including discomfort or postpr and ial fullness . However , there is little evidence of the efficacy of these drugs in patients with FD . We performed a r and omized , double-blind , placebo-controlled trial to evaluate the effects of antidepressant therapy on symptoms , gastric emptying ( GE ) , and meal-induced satiety in patients with FD . METHODS We performed a study at 8 North American sites of patients who met the Rome II criteria for FD and did not have depression or use antidepressants . Patients ( n = 292 ; 44 ± 15 years old , 75 % were female , 70 % with dysmotility-like FD , and 30 % with ulcer-like FD ) were r and omly assigned to groups given placebo , 50 mg amitriptyline , or 10 mg escitalopram for 10 weeks . The primary end point was adequate relief of FD symptoms for ≥5 weeks of the last 10 weeks ( of 12 ) . Secondary end points included GE time , maximum tolerated volume in Nutrient Drink Test , and FD-related quality of life . RESULTS An adequate relief response was reported by 39 subjects given placebo ( 40 % ) , 51 given amitriptyline ( 53 % ) , and 37 given escitalopram ( 38 % ) ( P = .05 , after treatment , adjusted for baseline balancing factors including all subjects ) . Subjects with ulcer-like FD given amitriptyline were > 3-fold more likely to report adequate relief than those given placebo ( odds ratio = 3.1 ; 95 % confidence interval : 1.1 - 9.0 ) . Neither amitriptyline nor escitalopram appeared to affect GE or meal-induced satiety after the 10-week period in any group . Subjects with delayed GE were less likely to report adequate relief than subjects with normal GE ( odds ratio = 0.4 ; 95 % confidence interval : 0.2 - 0.8 ) . Both antidepressants improved overall quality of life . CONCLUSIONS Amitriptyline , but not escitalopram , appears to benefit some patients with FD , particularly those with ulcer-like ( painful ) FD . Patients with delayed GE do not respond to these drugs . Clinical Trials.gov ID : NCT00248651
However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made .
Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition .