Efficacy of Tricyclic Antidepressant Therapy in Adults With Cyclic Vomiting Syndrome

Abstract

Long-term TCA therapy significantly reduces the frequency and duration of CVS episodes, ED visits, and hospitalizations (P<0.05), and improves overall clinical well-being providing evidence that they are effective therapy for adult CVS.

Challenges With Acute Care and Response to Treatment Among Adult Patients With Cyclic Vomiting Syndrome

“…Six participants (38%) reported never being prescribed any prophylaxis. Those who were prescribed prophylactic medications in the past and were no longer taking them (38%) discontinued the medications due to side effects, which is consistent with reports of 3%-50% experiencing side effects ( Boles, 2011 ;Boles et al, 2010 ;Hejazi, Reddymasu, et al, 2010 ;Namin et al, 2007 ;Prakash & Clouse, 1999 ). These findings show that healthcare providers should closely monitor effects and side effects of prescribed medications to maximize the effectiveness and decrease the likelihood of patients discontinuing treatment.…”

“…Gastroenterology Nursing 2010 ; Hejazi, Reddymasu, et al, 2010 ;Namin et al, 2007 ;Prakash& Clouse, 1999 ). Despite this knowledge, only four participants (25%) were currently taking tricyclic antidepressants to prevent CVS episodes; each reported a reduction in the frequency of episodes.…”

Cyclic vomiting syndrome in 28 patients

“…Patients with CVS are usually treated with either antidepressants, antimigrainous or antiepileptic medications [17,[22][23][24]. However, this cohort of patients is unique in that the majority of patients were only treated symptomatically.…”

Cyclic vomiting syndrome: a case series and review of the literature

“…The aim is to titrate the dosage of TCAD upwards in increments of 10–25 mg every few weeks, to the maximum tolerated dose, with the minimum number of side effects. In a study of 41 patients conducted by Hejazi et al ,32 the frequency and duration of acute episodes was significantly reduced with prophylactic TCADs, and clinical well-being was also improved. In a larger study containing 132 adult patients, factors influencing non-response to TCADs included chronic cannabis use, concomitant psychological illness, reliance on narcotic drugs in between episodes, or a history of migraine 53…”