Effects of Amitriptyline and Escitalopram on Sleep and Mood in Patients With Functional Dyspepsia

Linda M. Herrick, Michael Camilleri, Cathy D. Schleck, Alan R. Zinsmeister, Yuri Ann Saito Loftus, Nicholas J. Talley

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background & Aims: Tricyclic antidepressants are effective in reducing symptoms of functional dyspepsia (FD). We performed a post hoc analysis of data from a previous randomized clinical trial to determine whether the benefits of an antidepressant on gastrointestinal symptoms in patients with FD were mediated by improving sleep or reducing anxiety. We explored the relationships between psychological measures, quality of sleep, and relief of symptoms. Methods: We analyzed data from a multicenter, double-blind trial that evaluated the efficacy of antidepressants on symptoms of FD, from October 2006 through October 2012. Patients (n = 292) were randomly assigned to groups given 50 mg amitriptyline, 10 mg escitalopram, or placebo for 12 weeks. During the study, participants completed the following validated psychological questionnaires: Symptom Check List 90, Symptom Somatic Checklist, Hospital Anxiety Depression Scale, Profile of Mood States, State Trait Anxiety Inventory, and Pittsburgh Sleep Quality Index at baseline and 12 weeks following treatment. Results: Baseline scores for the psychological and sleep measures were similar among groups; after 12 weeks there were no significant differences in scores among groups. Baseline mean global Pittsburgh Sleep Quality Index scores indicated poor sleep quality in all groups at baseline and after 12 weeks. Overall, antidepressants affected sleep duration scores: patients given amitriptyline had lower (better) scores than patients given placebo or escitalopram (P =.019). In all groups, responders had decreased anxiety and improvements in some sleep components. Conclusions: In a post hoc analysis of data from a clinical trial that evaluated the effects of antidepressants in patients with FD, amitriptyline was found to reduce symptoms of FD, but its mechanism is unlikely to involve reductions in psychological distress. The drug may modestly improve sleep. Clinicaltrials.gov no: NCT00248651.

Original languageEnglish (US)
Pages (from-to)401-406.e2
JournalClinical Gastroenterology and Hepatology
Volume16
Issue number3
DOIs
StatePublished - Mar 1 2018

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Citalopram
Amitriptyline
Dyspepsia
Sleep
Antidepressive Agents
Anxiety
Psychology
Placebos
Tricyclic Antidepressive Agents
Checklist
Randomized Controlled Trials
Clinical Trials
Depression
Equipment and Supplies

Keywords

  • Antidepressants
  • Functional Dyspepsia
  • HADS
  • Mood
  • POMS
  • PSQI
  • SCL-90
  • Sleep
  • SSC
  • STAI

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Effects of Amitriptyline and Escitalopram on Sleep and Mood in Patients With Functional Dyspepsia. / Herrick, Linda M.; Camilleri, Michael; Schleck, Cathy D.; Zinsmeister, Alan R.; Saito Loftus, Yuri Ann; Talley, Nicholas J.

In: Clinical Gastroenterology and Hepatology, Vol. 16, No. 3, 01.03.2018, p. 401-406.e2.

Research output: Contribution to journalArticle

Herrick, Linda M. ; Camilleri, Michael ; Schleck, Cathy D. ; Zinsmeister, Alan R. ; Saito Loftus, Yuri Ann ; Talley, Nicholas J. / Effects of Amitriptyline and Escitalopram on Sleep and Mood in Patients With Functional Dyspepsia. In: Clinical Gastroenterology and Hepatology. 2018 ; Vol. 16, No. 3. pp. 401-406.e2.
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