Irritable bowel syndrome (IBS) is most commonly managed in primary care. However, when initial treatments prove ineffective, the UK National Institute for Health and Care Excellence recommends low-dose tricyclic antidepressants as a second-line option, although their effectiveness in this primary care context is uncertain. Despite this recommendation, these antidepressants are seldom prescribed in primary care for IBS patients. The ATLANTIS trial has now investigated the efficacy of low-dose amitriptyline, an antidepressant, as a second-line treatment for IBS in primary care.
In the study, low-dose amitriptyline (10-30 mg daily) demonstrated superiority over placebo after six months in patients aged 18 and over with persistent IBS. Overall, the titrated low-dose amitriptyline was deemed safe, well-tolerated, and an effective second-line option for managing IBS in primary care. The…
