title: Effect of amitriptyline on gastrointestinal function and brain-gut peptides: a double-blind trial.
abstract: OBJECTIVE
  To study the effects of low-dose amitriptyline (AMT) on gastrointestinal function and brain-gut peptides in healthy Chinese volunteers.
  
  
  METHODS
  This was a double-blind, randomised, placebo-controlled, two-period cross-over trial. Twenty-eight healthy volunteers were randomised and administered 1-wk treatments of AMT (12.5 mg tid) or placebo. Before and during the final two days of treatment, gastric emptying, proximal gastric accommodation and visceral sensitivity were measured by drinking-ultrasonography test; the orocecal transit time (OCTT) was measured by lactulose hydrogen breath test, and fasting blood was collected. Plasma levels of ghrelin, motilin and neuropeptide Y (NPY) were measured by enzyme-linked immunosorbent assay kits.
  
  
  RESULTS
  AMT slowed the OCTT (109.2 ± 29.68 min vs 96.61 ± 23.9 min, P = 0.004) but did not affect liquid gastric emptying and had no effect on proximal gastric accommodation. AMT resulted in decreases in the visual analogue scale (VAS) for difficulty in drinking 600 and 800 mL of water (3.57 ± 0.94 vs 2.98 ± 0.85, 5.57 ± 0.82 vs 4.57 ± 0.98, P < 0.01 for both), although it had no significant effect on the VAS for difficulty in drinking 200 mL and 400 mL of water. AMT significantly increased the plasma ghrelin level (442.87 ± 176.79 pg/mL vs 526.87 ± 158.44 pg/mL, P = 0.04) and the neuropeptide-Y level (890.15 ± 131.46 pg/mL vs 965.64 ± 165.63 pg/mL, P = 0.03), whereas it had no effect on the MTL level.
  
  
  CONCLUSIONS
  Low-dose AMT could slow OCTT, make the stomach less sensitive and increase the plasma levels of ghrelin and NPY. Thus, we recommend the use of low-dose AMT for functional gastrointestinal disorders.
authors.affiliation: Department of Gastroenterology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Shu-Man
authors.initials: SM
authors.lastname: Jiang
authors.forename: Lin
authors.initials: L
authors.lastname: Jia
authors.forename: Le-Qing
authors.initials: LQ
authors.lastname: You
authors.forename: Yao-Xing
authors.initials: YX
authors.lastname: Huang
authors.forename: Yan-Mei
authors.initials: YM
authors.lastname: Gong
authors.forename: Gui-Qin
authors.initials: GQ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000639:Amitriptyline / Q000008:administration & dosage*; D001921:Brain / Q000187:drug effects* / Q000378:metabolism; D002681:China; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D041981:Gastrointestinal Tract / Q000187:drug effects* / Q000294:innervation / Q000378:metabolism; D005772:Gastrointestinal Transit / Q000187:drug effects; D054439:Ghrelin / Q000097:blood*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D009037:Motilin / Q000097:blood*; D009478:Neuropeptide Y / Q000097:blood*; D012684:Sensory Thresholds / Q000187:drug effects; D013997:Time Factors; D055815:Young Adult
chemical_list: C515349:GHRL protein, human; D005765:Gastrointestinal Agents; D054439:Ghrelin; D009478:Neuropeptide Y; D000639:Amitriptyline; D009037:Motilin
keywords: Amitriptyline; Brain-gut peptides; Gastric emptying; Orocecal transit time; Visceral hypersensitivity