A three-month trial of amitriptyline offered sustained pain improvement in two-thirds of children diagnosed with functional abdominal pain disorders (FAPD), as per the outcomes of a study published in "Journal of Gastroenterology & Hepatology". This randomized, placebo-controlled, open-label trial was carried out for assessing the efficacy of amitriptyline for pediatric FAPD management.

Overall, 149 participants (age ≤eighteen years) were randomly segregated to either the amitriptyline group (n=75) or placebo group (n=74) for twelve weeks. A comparison was done of post-therapy improvement of pain and quality of life from baseline.

A substantial inter-group difference was noted in pain relief in terms of decline in scores for intensity, frequency, duration, and quality of life. In the amitriptyline group, a greater percentage of responders reported >50% decline in pain when compared to the placebo group. The occurrence of minor adverse events was similar between the groups, as illustrated in Table 1:

On multivariate assessment, amitriptyline use was the only factor predictive of response (odds ratio 24.1). Notably, 89% of children (24/27) who had extended therapy duration (6.8±1.8 months) experienced a decrease in pain. Following amitriptyline discontinuation, 70% exhibited a sustained response over a mean follow-up of 15.84±5.6 months. The safety profile and efficacy of amitriptyline necessitate more frequent usage in the clinical settings, concluded the study researchers.