Tianeptine <i>vs</i> amitriptyline for the treatment of irritable bowel syndrome with diarrhea: a multicenter, open‐label, non‐inferiority, randomized controlled study

Sohn, Woon Mok; Lee, O. Y.; Kwon, Jung-Hyun; Park, K. S.; Lim, Yun Jeong; Kim, T. H.; Jung, Susie; Kim, J. I.

doi:10.1111/j.1365-2982.2012.01945.x

Cited by 17 publications

(14 citation statements)

References 45 publications

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“…There were a total of 15 publications that explicitly recorded the frequency or types of sexual function change under amitriptyline use. They included one observational study ( Couper-Smartt & Rodham, 1973 ), one review study ( Montgomery, 1995 ), eight randomized case-control or case-placebo clinical trials ( Bremner, 1995 ; Hekimian, Friedhoff, & Deever, 1978 ; Mathur, Sharma, Choudhary, & Jain, 2005 ; Reimherr et al, 1990 ; Sohn et al, 2012 ; Stahl, Zivkov, Reimitz, Panagides, & Hoff, 1997 ; van Ophoven, Pokupic, Heinecke, & Hertle, 2004 ; Zivkov & de Jongh, 1995 ), and five clinical case reports ( Lucca, Ramesh, Ram, Kurian, & Mathew, 2016 ; Mitchell & Popkin, 1983 ; Nininger, 1978 ; Rao, Morriss, & Michael, 1998 ; Simpson et al, 1965 ). The review study, which included pooled clinical and preclinical trials of mirtazapine (Org 3770) in Europe and the United States before 1995, was discarded from this study as the demographic information was not fully described and part of the data has been published in another study ( Montgomery, 1995 ).…”

Section: Resultsmentioning

confidence: 99%

“…In the eight randomized clinical trials, the quality was considered good in four trials ( Reimherr et al, 1990 ; Sohn et al, 2012 ; Stahl, Zivkov, Reimitz, Panagides, & Hoff, 1997 ; Zivkov & de Jongh, 1995 ) due to a prospective design, a high follow-up rate (> 80%), an adequate number of patients and controls (100-200 subjects in each group), a clear main outcome and a rational methodology for sexual and clinical assessment (LOE: IIb). In another four trials ( Bremner, 1995 ; Hekimian et al, 1978 ; Mathur et al, 2005 ; van Ophoven et al, 2004 ), the design, follow-up rate, outcome and methodology were similar except for a modest number of patients and controls (less than 100 subjects in either group) (LOE: IIIb).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice

Chen

Lian

et al. 2017

Am J Mens Health

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Amitriptyline is an old drug but is still prevalently used as the first-line treatment for a variety of common diseases. Surprisingly, knowledge of sexual risks with amitriptyline comes from only one clinical trial and several case reports from three decades ago. In the current study, a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) related to amitriptyline and sexual dysfunction (SD) was performed. The frequency, gender-difference, types, disease-specificity and time course of SD, and the relationship between SD and nonsexual adversity were studied. A total of 14 publications, including 8 qualified randomized clinical trials, were eligible. The frequency of SD in overall, male and female patients was 5.7, 11.9 and 1.7%, respectively. SD was six-fold higher in men than women. The frequency of SD was 6.9% in depressive patients compared with 0.8% in non-depressive patients (p = .008), and gradually decreased at 8 weeks after treatment (p = .02). Amitriptyline impacted arousal and libido more than orgasm and ejaculation in male patients but mainly libido in female patients. SD was significantly correlated with insomnia linearly whereas somnolence and nausea dually. Therefore, amitriptyline-associated SD mainly occurs in depressive and male patients, disturbs each phase of the sexual response cycle in men but mainly libido in women, gradually decreases under long-term treatment, and can be predicted by the co-existence of insomnia, somnolence or nausea during treatment. Clinicians should caution and tailor the gender and disease vulnerability of amitriptyline in their practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice

Chen

Lian

et al. 2017

Am J Mens Health

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“…Eighty-eight percent in the tianeptine compared to 66 % in the amitriptyline group reported relief of global symptoms of IBS. Further, side effects of dry mouth and drowsiness were fewer in the tianeptine group compared to amitriptyline [30].…”

Section: Traditional Medications For Abdominal Pain In Ibs-dmentioning

confidence: 91%

Novel Therapies in IBS-D Treatment

Nee

Zakari

Lembo

2015

Curr Treat Options Gastro

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Irritable bowel syndrome (IBS) is a common gastrointestinal disease characterized by abdominal pain and change in bowel habits. IBS diarrhea predominant (IBS-D), which is arguably the most common subset of IBS, is also associated with rectal urgency, increased frequency, abdominal bloating, and loose to watery stools. Current treatments for diarrhea include mu-opioid agonists (i.e., loperamide, lomotil) and bile acid sequestrants (i.e., cholestyramine) while treatments for abdominal pain include antispasmodics (i.e., hyoscyamine, dicyclomine) and tricyclic antidepressants (i.e., amitriptyline). There are currently 3 FDA-approved treatments for IBS-D, which have been shown to improve both abdominal pain and diarrhea. Alosetron was initially approved by FDA 2000; however, its use is now limited to women with severe IBS-D symptoms refractory to other treatment. Eluxadoline, a mixed mu-opioid agonist, and rifaximin, a broad spectrum gut specific antibiotic, were both FDA approved in 2015. Eluxadoline has been shown to relieve abdominal pain and stool consistency in appropriate candidates. While large trials already showed the efficacy of rifaximin in treating non-constipated IBS for bloating, stool consistency, and abdominal pain, the recent TARGET 3 trial demonstrates that retreatment is also effective. While these new treatments significantly expand options for patients suffering from IBS-D, there is likely to remain a need for additional safe and effective therapies.

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“…116 In addition, SSRIs did not improve abdominal pain or enhance the QOL of the IBS patients. SSRIs promote peristalsis and thus are considered to be more effective for IBS-C than IBS-D. 117 A recent study in Korea reported that the selective 5-HT reuptake enhancer tianeptine was not inferior to the TCA amitriptyline in providing global relief of IBS symptoms (abdominal pain/ discomfort, stool frequency/consistency, QOL, and overall treatment satisfaction) in patients with IBS D. 121 Therefore, SSRIs may provide some degree of symptom relief in a subset of patients with IBS. SSRIs are more tolerable and have fewer side effects compared with TCAs, and the risk of critical adverse events is minimal.…”

Section: • Grade Of Recommendation: 2 • Level Of Evidence: B • Not Vomentioning

confidence: 99%

Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition

Song

Jung

Kim

et al. 2018

J Neurogastroenterol Motil

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In 2011, the Korean Society of Neurogastroenterology and Motility (KSNM) published clinical practice guidelines on the management of irritable bowel syndrome (IBS) based on a systematic review of the literature. The KSNM planned to update the clinical practice guidelines to support primary physicians, reduce the socioeconomic burden of IBS, and reflect advances in the pathophysiology and management of IBS. The present revised version of the guidelines is in continuity with the previous version and targets adults diagnosed with, or suspected to have, IBS. A librarian created a literature search query, and a systematic review was conducted to identify candidate guidelines. Feasible documents were verified based on predetermined inclusion and exclusion criteria. The candidate seed guidelines were fully evaluated by the Guidelines Development Committee using the Appraisal of Guidelines for Research and Evaluation II quality assessment tool. After selecting 7 seed guidelines, the committee prepared evidence summaries to generate data exaction tables. These summaries comprised the 4 main themes of this version of the guidelines: colonoscopy; a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; probiotics; and rifaximin. To adopt the core recommendations of the guidelines, the Delphi technique (ie, a panel of experts on IBS) was used. To enhance dissemination of the clinical practice guidelines, a Korean version will be made available, and a food calendar for patients with IBS is produced.

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Tianeptine vs amitriptyline for the treatment of irritable bowel syndrome with diarrhea: a multicenter, open‐label, non‐inferiority, randomized controlled study

Abstract: Tianeptine is not inferior to amitriptyline for treating IBS-D in terms of both efficacy and tolerability.

Cited by 17 publications

References 45 publications

Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice

Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice

Novel Therapies in IBS-D Treatment

Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition

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