Application of amitriptyline in the treatment of interstitial cystitis / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the safety and efficacy of the trieyelic antidepressant amitrip tyline in the treatment of patient with interstitial cystitis (IC). Methods Fifty-four patients diagnosed with IC were recruited in this prospective three-month clinical trial. The average course of patient's history was (40. 75±11.6)months, ranging from 19-72 months. All the 54 patients received oral administration of amitriptyline for 3 months. The initial dosage of amitriptyline was 25 mg per night. After 1 week, the dosage would be increased to 50 mg if the symptom didn't relief. After another 1 week, the dosage would be increased to 75 mg if the symptoms were still exist. The patients were kept on a minimum dosage which could relief patient's IC symptoms. Clinical symptoms, such as frequency per day, maximal voiding volume and odynuria degree score, O'Leary-Sant IC symptom and problem index and quality of life score were recorded and assessed at the beginning of the study and 3 months after the treatment. Results After 3 month treatment, the pre-treatment vs post-treatment parameters of frequency per day was 28.5±8. 4 vs 15.6±3.3, odynuria degree score was 6.4± 1.5 vs 2.2±1.5 and maximal voiding volume was 108.7±62.2 ml vs 171.0±53.9 ml respectively. There was significant improvement in all the above parameters comparing between the baseline and 3 months after the treatment. At the 3 months after treatment, the pre-treatment vs post-treatment O'Leary-Sant IC symptom and problem index and quality of life score was 26.9±4.0 vs 13.7±5.7 and 5.5±0. 5 vs 2.5±0. 6, receptively. There were significant decreases compared with the baseline. There was no serious adverse event after taking amitriptyline. Drowsiness occurred in 45 of the 54 patients at the first month administration. Of the 45 patients, 43 patients relieved and 2 patients quitted from the study. Mild weight increase was noted in 10 patients. Mild constipation was recorded in 11 patients. Mouth dryness was recorded in 9 patients. Three patients quitted because of suffering dysuria. Conclusions Oral administration of amitriptyline can effectively relieve clinical symptoms of IC and improve IC patients" quality of life. The side effects are well tolerated.