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From: Kofi on 2 May 2008 03:00
http://www.sciencedaily.com/releases/2008/05/080501154222.htm

Antidepressant Found To Alleviate Symptoms Of Irritable Bowel Syndrome
In Adolescents

ScienceDaily (May 2, 2008) � Researchers at Mattel Children's Hospital
UCLA have found that low-dose antidepressant therapy can significantly
improve the overall quality of life�for adolescents suffering from
irritable bowel syndrome, or IBS. The syndrome affects 6 percent of
middle school students and 14 percent of high school kids in the United
States.

The study, published in the May issue of the peer-reviewed Journal of
Pediatrics,�is the first of its kind to look at the effects of
amitriptyline, a tricyclic antidepressant, in the pediatric IBS
population, researchers said.

The�research was conducted�between 2002 and�2005 and involved 33 newly
diagnosed IBS patients, including 24�girls, between the ages of 12 and
18.

Irritable bowel syndrome�causes discomfort in the abdomen, along with
diarrhea,�constipation or both. Currently, there is no cure, and
treatments only lessen the symptoms.

"While research has shown that amitriptyline is effective for adults
with IBS, only peppermint oil has been studied in children with this
disorder in a double-blind, placebo-controlled fashion," said Dr. Ron J.
Bahar, assistant clinical professor of pediatric gastroenterology at
Mattel Children's Hospital UCLA and lead author of the study. "Our
results show that amitriptyline significantly improves overall
quality-of-life measurements in adolescents and should be a therapeutic
option for these patients. We were actually surprised to reach our
conclusion with a relatively small number of subjects."

The 13-week study�consisted of�three phases: two weeks of enrollment and
symptom scoring, eight weeks of therapy with�amitriptyline or a placebo,
and three weeks of post-medication "washout" and symptom scoring.

Patients were randomized in a double-blinded fashion to receive�the
antidepressant�or a placebo and were surveyed at two, six, 10 and 13
weeks�using a symptom checklist, a pain-rating scale, a pain intensity
and frequency scale, and an IBS quality-of-life questionnaire.

The results showed that patients receiving�amitriptyline were more
likely to experience:

* An improvement in overall�quality of life�at six, 10 and 13 weeks.
* A reduction in IBS-associated diarrhea at�six and 10 weeks.
* A reduction in pain near the belly button at 10 weeks.
* A reduction in�pain in the right lower quadrant of the abdomen�at
six, 10 and 13 weeks.

Bahar�said that more than half�of�eligible�patients, or their parents or
guardians, refused to enroll in the study because they were
uncomfortable with using an antidepressant medication of any kind,
citing negative reports in the media about their side effects and the
Food and�Drug Administration's formal 2004 "black box" warnings
regarding the increased potential for suicide in children using
antidepressants.

"However, the dose of AMI (amitriptyline) used in this study, as well as
IBS treatment for adults, is far less than the dose to treat
depression," Bahar said. "At these low levels, it could be considered a
remedy to treat neuropathic pain associated with chronic pain symptoms,
rather than an antidepressant or psychotropic medication."
The next stage of research will look at the long-term follow-up of these
patients to determine who will continue to stay well on the medication,
whose symptoms resolve spontaneously and what other medications can be
used as an alternative to amitriptyline for adolescents with IBS.

The research was funded by James L. Brooks and the Diane Brooks Medical
Research Foundation of the California Community Foundation, and by the
pharmaceutical company AstraZeneca.

Other study authors included Dr. Brynie S. Collins, Dr. Barry Steinmetz
and Dr. Marvin Ament.

Adapted from materials provided by University of California - Los
Angeles.

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Also of relevance, 20mg daily of fluoxetine (Prozac) limits new brain
areas affected by multiple sclerosis
<http://www.sciencedaily.com/releases/2008/04/080430201648.htm>.
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