Effect of Low-Dose Amitriptyline Treatment for Interstitial Cystitis/Bladder Pain Syndrome

Abstract

Objective: The primary purpose of this study is to evaluate the efficacy and safety of low-dose amitriptyline therapy on symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Patients and Methods: Between September 2015 and December 2016, 102 patients with IC/BPS received low-dose amitriptyline therapy (25 mg/d, before bedtime) at a 12-week course. The outcome measures used were IC symptom index and IC problem index (ICSI/ICPI), 24-h frequencyvolume chart, and visual analog scale (VAS), which were completed before and 4 and 12 weeks after amitriptyline treatment. Results: A total of 89 patients (mean age of 61.9 years) with IC/BPS were recruited in this low-dose amitriptyline therapy study. The response rate was 66.3% (89 patients). Compared with baseline, the various IC symptoms improved significantly. Comparing values before treatment and 4 and 12 weeks after treatment (baseline vs. 4 weeks-baseline vs. 12 weeks), the rates of improvement were as follows: ICSI -38.42%-49.61%, ICPI -45.04%-53.20%, 24-h frequency -45.54%-50.83%, VAS -41.18%-70.01%, and function bladder volume -+139 ml-+122 ml, which showed statistically significant differences (P < 0.05). However, comparing values at 4 and 12 weeks after treatment (4 weeks vs. 12 weeks), only VAS and urgency showed a statistically significant decrease (P < 0.05). Side effects occurred in 72 patients (80.90%), primarily including mouth dryness (66.30%) and drowsiness (49.44%). Conclusion: Low-dose amitriptyline therapy is a feasible, effective, and safe treatment for the subgroup of patients with IC/BPS in a short term.