Nortriptyline Is Not Effective for Gastroparesis Symptoms

The tricyclic antidepressant was not more efficacious than placebo for reducing symptoms and was poorly tolerated in a 15-week randomized trial.

Current pharmacologic therapies for gastroparesis are limited by adverse effects (e.g., metoclopramide), lack of availability (e.g., doperidone), and tachyphylaxis (e.g., erythromycin). Because associated symptoms of nausea, emesis, and abdominal pain have been attributed to neuropathic changes in the enteric and sensory nerves, tricyclic antidepressants (TCAs) have been used as neuromodulators, but data supporting their use are limited.

In a 15-week, multicenter, parallel-group, double-blind trial, investigators compared the efficacy of the TCA nortriptyline and placebo for symptom relief in 130 patients with moderate-to-severe symptoms due to idiopathic gastroparesis. Dosing of oral capsule medication was escalated at 3-week intervals in b…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors