New data from the ATLANTIS clinical trial, presented at UEG Week 2023, suggests that amitriptyline, a medication already in common use, may substantially mitigate the symptoms of irritable bowel syndrome (IBS), providing a fresh therapeutic option for patients.
This inexpensive and broadly accessible prescribed medication has been found to enhance the condition of irritable bowel syndrome patients treated in general practice, according to recent research. This information was unveiled at UEG Week 2023, an event organized by the European Society of Gastrointestinal Endoscopy.
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The Scope of the ATLANTIS Trial
In the ATLANTIS study, amitriptyline, a medication frequently administered in low dosages for various health issues, also exhibited efficacy in reducing IBS symptoms.
The study was led by academic teams from the Universities of Leeds, Southampton, and Bristol and was financially supported by the National Institute for Health and Care Research (NIHR). It was carried out in a primary healthcare setting where general practitioners (GPs) prescribed the drug. Patients were responsible for modulating their own dosage in alignment with their symptom severity, using a guide specifically formulated for this study. The trial’s results are highly relevant as most IBS patients receive treatment from their GPs in primary care settings.
Published Results Indicate Efficacy
The findings, disclosed this month in The Lancet, indicated that patients ingesting amitriptyline were nearly twice as likely to experience overall symptom improvement compared to those given a placebo.
Following the outcomes of the study, the research team is advising GPs to consider prescribing amitriptyline for IBS symptom management and has made the dosage adjustment guide accessible for healthcare providers and patients alike.
Expert Commentary
Alexander Ford, the Co-Chief Investigator and Professor of Gastroenterology at the University of Leeds’s School of Medicine, commented, “Amitriptyline appears to be a safe and effective treatment for IBS. Our rigorous study implies that general practitioners in primary care should consider supporting their IBS patients with low-dose amitriptyline if initial treatments are ineffective.”
Background on IBS and Amitriptyline
IBS affects roughly 5% of the global population and is characterized by abdominal discomfort and altered bowel habits. It is a chronic condition with an unpredictable course and can significantly impair one’s quality of life and social interactions. Current treatments often offer only modest relief.
Amitriptyline is part of the tricyclic antidepressants category. Though once used in higher dosages to treat depression, it is rarely used for this purpose today due to the advent of newer medications.
Supporting Recommendations and Insights
General practitioners already prescribe low doses of amitriptyline for other issues such as chronic pain and migraine prevention. However, until this study, there was a lack of robust evidence to support its use in treating IBS symptoms.
Study Participants and Conclusions
The ATLANTIS study involved 463 participants from three UK regions and was conducted across 55 general practices. Patients were divided into two categories: those receiving amitriptyline and those given a placebo. A substantial improvement in symptom scores after six months was noted among the amitriptyline group.
No significant alterations were found in the anxiety or depression scores of the participants, suggesting the drug’s beneficial effects are gastrointestinal rather than psychological.
Concluding Remarks
Andrew Farmer, Director of NIHR’s Health Technology Assessment (HTA) Programme, summarized, “This study offers encouraging results. The research findings can greatly assist general practitioners in effective patient treatment for IBS, a condition that affects a significant portion of the UK population and can be debilitating.”
Additional Information
IBS symptom scores were gauged using the IBS-SSS scale. Those on amitriptyline experienced a 99-point improvement, whereas the placebo group showed a 69-point improvement.
Reference: “Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment in Primary Care (ATLANTIS): A Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial” by a comprehensive list of investigators, published on 16 October 2023 in The Lancet.
DOI: 10.1016/S0140-6736(23)01523-4
Frequently Asked Questions (FAQs) about Amitriptyline for IBS Treatment
What is the ATLANTIS trial?
The ATLANTIS trial is a research study led by the Universities of Leeds, Southampton, and Bristol, and funded by the National Institute for Health and Care Research (NIHR). The study investigated the efficacy of the drug amitriptyline in treating symptoms of irritable bowel syndrome (IBS).
What drug does the ATLANTIS trial focus on for treating IBS symptoms?
The ATLANTIS trial focuses on the prescription drug amitriptyline, commonly used at low doses for various health concerns. The study aims to ascertain whether this drug can effectively alleviate symptoms of IBS.
Where were the results of the ATLANTIS trial published?
The findings of the ATLANTIS trial were published in The Lancet, a reputable medical journal. The results indicate that amitriptyline significantly improves symptoms in IBS patients.
Are the findings of the ATLANTIS trial applicable to general practitioners?
Yes, the study was conducted in primary care settings and most IBS patients are managed by their general practitioners (GPs). Therefore, the results are directly applicable to the management of IBS symptoms in a primary care context.
What were the significant results of the ATLANTIS trial?
Patients taking amitriptyline reported almost twice the overall improvement in IBS symptoms compared to those on a placebo. The trial supports the use of low-dose amitriptyline for IBS symptoms, especially when first-line treatments have failed.
How does amitriptyline usually function, and is it safe for IBS?
Amitriptyline is part of a group of medications called tricyclics, originally used at high doses for treating depression. In this study, it was found to be safe and well-tolerated for IBS treatment, with side effects generally being mild.
How many participants were involved in the ATLANTIS trial?
The ATLANTIS trial involved 463 participants with IBS from three regions across the UK, including West Yorkshire, Wessex, and the West of England. Participants were recruited from 55 general practices.
What is the recommendation for GPs based on the ATLANTIS trial?
Based on the successful outcomes of the trial, it is recommended that GPs consider prescribing low-dose amitriptyline to IBS patients as part of shared decision-making, especially if first-line treatments have not proven effective.
Were any other conditions like anxiety or depression affected by amitriptyline use in the trial?
The study monitored participants for anxiety and depression and found no significant alteration in scores, indicating that the beneficial effects were specific to treating IBS symptoms.
What is the impact of IBS on people’s lives, and how could this study help?
IBS affects approximately 1 in 20 people globally and can severely impact quality of life and work productivity. This trial offers a new avenue for symptom management, which could significantly improve the quality of life for those affected by the condition.
More about Amitriptyline for IBS Treatment
- The Lancet Journal
- National Institute for Health and Care Research (NIHR)
- European Society of Gastrointestinal Endoscopy
- University of Leeds’s School of Medicine
- University of Southampton Primary Care Research Centre
- University of Bristol Centre for Academic Primary Care
- NICE Guidelines on Irritable Bowel Syndrome
- IBS-SSS Scale Information
8 comments
I have to say the researchers from Leeds, Southampton, and Bristol are doing great work. Hope this leads to effective treatment for more people.
Wait, amitriptyline was for depression right? so how did they come up with this for IBS? But hey, if it works, it works.
This is big news! I’ve been suffering from IBS for years and nothing really worked for me. amitriptyline could be a game changer.
Seems promising but isnt this a pretty old drug? How does it compare to newer meds? Would love to hear more about that.
Finally some good news for those of us struggling with IBS! But, is it available for everyone or just in the UK? Need to kno.
interesting, but what about the side effects? you mentioned dry mouth but are there other things to consider?
The fact that the study was conducted in primary care is encouraging. means the results could be more applicable to general public.
So it’s a double-blind study, which means it should be reliable. Good to see rigorous research being done on IBS, its about time.