Electrocardiograms changes in children with functional gastrointestinal disorders on low dose amitriptyline.

Abstract

AIM:

To study the effects of low dose amitriptyline on cardiac conduction in children.

METHODS:

Secondary analysis of data obtained from a double-blind, randomized placebo-controlled trial, evaluating low dose amitriptyline in children with a diagnosis of functional abdominal pain, functional dyspepsia, and irritable bowel syndrome according to the Rome II criteria. Children 8-17 years of age were recruited from the pediatric gastroenterology clinics of 6 tertiary care centers in the United States. The electrocardiograms (EKGs) done prior to initiation of amitrityline and 1 mo after initiation of amitriptyline were examined. The changes in cardiac conduction were evaluated in patients and controls.

RESULTS:

Thirty children were included in the study. There were 12 patients, ages 9-17 years of both genders, in the amitriptyline treatment group and 18 patients, ages 9-17 years of both genders, in the placebo treatment group. None of the patients had any baseline EKG abnormality. Amitriptyline use was associated with an increase in heart rate (P = 0.024) and QTc interval (P = 0.0107) as compared to pre-EKGs. Children in the placebo group were also noted to present a statistically significant increase in QTc interval (P = 0.0498). None of the patients developed borderline QTc prolongation or long-QT syndrome after they were started on amitriptyline.

CONCLUSION:

The study findings suggest that once patients with functional gastrointestinal disorders have been screened for prolonged QTc interval on baseline EKG, they probably do not need a second EKG for reevaluation of cardiac conduction after starting low dose amitriptyline.

• Authors: Ashish Chogle, Miguel Saps
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 20 Issue 32 Pg. 11321-5 (Aug 28 2014) ISSN: 2219-2840 [Electronic] United States
• PMID: 25170217 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Antidepressive Agents, Tricyclic
• Amitriptyline

Topics

• Adolescent
• Age Factors
• Amitriptyline (administration & dosage, adverse effects)
• Antidepressive Agents, Tricyclic (administration & dosage, adverse effects)
• Child
• Electrocardiography
• Female
• Gastrointestinal Diseases (diagnosis, drug therapy, physiopathology)
• Heart Conduction System (drug effects, physiopathology)
• Heart Rate (drug effects)
• Humans
• Male
• Predictive Value of Tests
• Randomized Controlled Trials as Topic
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Tertiary Care Centers
• Time Factors
• Treatment Outcome
• United States