Effect of amitriptyline on gastrointestinal function and brain-gut peptides: A double-blind trial

Huang, Wei; Jiang, Shu-Man; Lin, Jianhua; You, Le-Qing; Huang, Yaoxing; Yan-mei, Gong; Wang, Guiqin

doi:10.3748/wjg.v19.i26.4214

Cited by 36 publications

(28 citation statements)

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“…The literature supports this hypothesis. Huang et al [26] demonstrated that at least in healthy volunteers, low dose of amitriptyline make the stomach less sensitive and increase the plasma levels of ghrelin. However, more studies are necessary to confirm this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Gastroduodenal Symptoms in Inflammatory Bowel Disease Are Correlated with Gastric Emptying and Serum Levels of Active Ghrelin

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Cavalcanti

Souza

et al. 2019

Dig Dis

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Background: Inflammatory bowel disease (IBD) is associated with delay in gastric emptying, increase in ghrelin, and decrease in leptin. The aim was to investigate the correlation between gastroduodenal (GD) symptoms, gastric emptying, and serum levels of active ghrelin and leptin in IBD. Twenty-seven IBD patients and 26 healthy volunteers were asked to complete the Porto Alegre Dyspeptic Symptoms Questionnaire. A gastric emptying test for solids was performed using a C13 octanoic acid breath test. During this test, serum samples were collected for measuring active ghrelin and leptin concentrations by radioimmunoassay. Summary: Patients with IBD demonstrated delayed gastric emptying compared with healthy volunteers. In patients with GD symptoms, the delay in gastric emptying was more pronounced, and there were significant correlations of satiety and vomiting with gastric emptying. Basal leptin, but not active ghrelin, increased in patients with GD symptoms compared with patients without these symptoms. There were negative correlations between basal active ghrelin with total Porto Alegre score and epigastric pain in IBD patients with GD symptoms. Key Messages: In IBD, satiety and vomiting were associated with delay in gastric emptying. Conversely, epigastric pain had a negative correlation with active ghrelin. Our results suggest that different pathophysiological mechanisms contribute to GD symptoms in IBD.

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Section: Discussionmentioning

confidence: 99%

Gastroduodenal Symptoms in Inflammatory Bowel Disease Are Correlated with Gastric Emptying and Serum Levels of Active Ghrelin

Sales

Cavalcanti

Souza

et al. 2019

Dig Dis

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“…We observed that low-dose AMT is well tolerated and can significantly improve patient symptoms, sleep, and quality of life. Low-dose AMT may be an effective treatment for globus pharyngeus [4. A previous study suggested that AMT could modify brain-gut axis function, upregulating brain-gut peptides, reducing the visceral sensitivity, and regulating the secretory and motor functions of the GI tract [4]; thus, the GI symptoms and emotional well-being could be significantly improved.…”

Section: Discussionmentioning

confidence: 99%

“…Low-dose AMT may be an effective treatment for globus pharyngeus [4. A previous study suggested that AMT could modify brain-gut axis function, upregulating brain-gut peptides, reducing the visceral sensitivity, and regulating the secretory and motor functions of the GI tract [4]; thus, the GI symptoms and emotional well-being could be significantly improved. In the present study, we observed that PAR therapy is more efficacious than empirical high-dose antacid treatment or even the low-dose AMT therapy in alleviating globus symptoms and producing global improvements for refractory globus patients [30].…”

Section: Discussionmentioning

confidence: 99%

“…Among the 182 subjects who completed the same questionnaires, 160 subjects (63 men and 97 women) did not have any globus symptoms or psychological disorders as a control group. Treatment response [4] was defined as a >50% reduction in the GETS score. The response was calculated as follows: ([score at treatment – score at baseline]/score at baseline) ×100%.…”

Section: Methodsmentioning

confidence: 99%

“…A previous study showed that low-dose amitriptyline (AMT) is well tolerated and effective for general globus pharyngeus patients [3]. Previous studies have suggested that AMT could modify brain-gut axis function, thereby upregulating brain-gut peptides, reducing the visceral sensitivity, and regulating the secretory and motor functions of the gastrointestinal (GI) tract [4]; thus, GI symptoms and emotional well-being could be significantly improved. Serotonin 5-hydroxtryptamine (5-HT) is an important factor in gut function, playing a key role in intestinal peristalsis, secretion, and sensory signaling in the brain-gut axis [5, 6].…”

Section: Introductionmentioning

confidence: 99%

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Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects

et al. 2018

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Background: Although globus pharyngeus is not rare in clinical practice, little is known about its associated gene polymorphism. We investigated the association between the SLC6A4 polymorphism and globus pharyngeus and its response to treatment with antidepressants. Methods: A total of 84 patients were diagnosed with globus pharyngeus according to Rome III, and 160 healthy controls were genotyped for the SLC6A4 polymorphism using polymerase chain reaction amplification and agarose gel electrophoresis. All patients with globus were studied using high-resolution manometry pre-therapy. Globus patients were randomized into paroxetine or amitriptyline groups for a 6-week treatment and asked to complete the following pre- and post-therapy questionnaires: the Glasgow Edinburgh Throat Scale (GETS), the Pittsburgh Sleep Quality Index, and the Hamilton Rating Scale Anxiety/Depression. Treatment response was defined as a >50% reduction in the GETS scores. Results: A significant difference was observed in the globus S/S genotype with anxiety compared to that without anxiety (χ² = 14.579, p = 0.006). The L/S genotype showed a significant difference between high upper esophageal sphincter pressure (>104 mm Hg) and non-high upper esophageal sphincter pressure patients (χ² = 14.433, p = 0.006). A significant association between the S/S genotype and the response to antidepressant treatment was also observed, while patients with sleep disorders or depression showed no association. Conclusion: A significant association was observed between the S/S genotype of the SLC6A4 polymorphism and globus pharyngeus, suggesting that SLC6A4 is a potential candidate gene involved in the pathogenesis of globus pharyngeus.

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Effects of Low-Dose Amitriptyline on Epigastric Pain Syndrome in Functional Dyspepsia Patients

et al. 2020

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Aim To observe the therapeutic effect of low-dose amitriptyline (AMT) on epigastric pain syndrome (EPS) in patients with functional dyspepsia. Methods Sixty patients with EPS were randomly divided into the following two groups for a four-week clinical trial: routine treatment with pantoprazole (RT group) and the AMT group. The RT group was treated with 40 mg of pantoprazole once daily. The AMT group received 25 mg of AMT once daily before bedtime. The Nepean Dyspepsia Index (NDI) checklist, Hamilton Rating Scale of Anxiety/Depression (HAMA/HAMD), and Pittsburgh Sleep Quality Index (PSQI) were employed to evaluate dyspepsia symptoms, psychological distress, and sleep, respectively. Results All items were similar between the two groups before treatment (0 week). After 4 weeks of treatment, the NDIsymptom checklist score as well as the severity and bothersomeness of EPS in the AMT group was significantly decreased compared with those in the RT group (p < 0.05). However, no differences were found in the frequency of NDI checklist, psychological status (HAMD/HAMA scores) of EPS, or sleep quality (PSQI score) between the two groups after treatment. In addition, the time to fall asleep was shorter in the AMT group compared with the RT group after 4 weeks of treatment (p < 0.05). Conclusion Low-dose AMT effectively improved the dyspepsia symptoms and the time to fall asleep in the EPS patients, compared with pantoprazole, although it did not reduce the psychological distress. Therefore, AMT could be considered as a good candidate for EPS treatment in the clinic.

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Effect of amitriptyline on gastrointestinal function and brain-gut peptides: A double-blind trial

Abstract: Low-dose AMT could slow OCTT, make the stomach less sensitive and increase the plasma levels of ghrelin and NPY. Thus, we recommend the use of low-dose AMT for functional gastrointestinal disorders.

Cited by 36 publications

References 0 publications

Gastroduodenal Symptoms in Inflammatory Bowel Disease Are Correlated with Gastric Emptying and Serum Levels of Active Ghrelin

Gastroduodenal Symptoms in Inflammatory Bowel Disease Are Correlated with Gastric Emptying and Serum Levels of Active Ghrelin

Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects

Effects of Low-Dose Amitriptyline on Epigastric Pain Syndrome in Functional Dyspepsia Patients

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