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Low-dose amitriptyline combined with proton pump inhibitor for functional chest pain

 Se Woo Park  ;  Hyuk Lee  ;  Hyun Jik Lee  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee  ;  Ji Eun Kim 
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.19(30) : 4958-4965, 2013 
Journal Title
Issue Date
Adrenergic Uptake Inhibitors/administration & dosage* ; Adult ; Amitriptyline/administration & dosage* ; Chest Pain/diagnosis ; Chest Pain/drug therapy* ; Chest Pain/etiology ; Chest Pain/psychology ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Prospective Studies ; Proton Pump Inhibitors/administration & dosage* ; Quality of Life ; Rabeprazole/administration & dosage* ; Republic of Korea ; Time Factors ; Treatment Outcome
Amitriptyline ; Functional chest pain ; Proton pump inhibitor
AIM: To investigate the efficacy of amitriptyline with proton pump inhibitor (PPI) for the treatment of functional chest pain (FCP). METHODS: This was a randomized, open-label trial investigating the addition of low dose amitriptyline (10 mg at bedtime) to a conventional dose of rabeprazole (20 mg/d) (group A, n = 20) vs a double-dose of rabeprazole (20 mg twice daily) (group B, n = 20) for patients with FCP whose symptoms were refractory to PPI. The primary efficacy endpoints were assessed by global symptom score assessment and the total number of individuals with > 50% improvement in their symptom score. RESULTS: The between-group difference in global symptom scores was statistically significant during the last week of treatment (overall mean difference; 3.75 ± 0.31 vs 4.35 ± 0.29, the between-group difference; P < 0.001). Furthermore, 70.6% of patients in group A had their symptoms improve by > 50%, whereas only 26.3% of patients in group B had a similar treatment response (70.6% vs 26.3%, P = 0.008). Specifically, patients in group A had a significantly greater improvement in the domains of body pain and general health perception than did patients in group B (52.37 ± 17.00 vs 41.32 ± 12.34, P = 0.031 and 47.95 ± 18.58 vs 31.84 ± 16.84, P = 0.01, respectively). CONCLUSION: Adding amitriptyline to a PPI was more effective than a double-dose of PPI in patients with FCP refractory to a conventional dose of PPI.
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1. College of Medicine (의과대학) > Medical Research Center (임상의학연구센터) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ji Eun(김지은)
Park, Se Woo(박세우)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
Lee, Hyun Jik(이현직)
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