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Long-Term Outcome from Tricyclic Antidepressant Treatment of Functional Chest Pain

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Abstract

Antidepressants are of demonstrated value inshort-term treatment of functional chest pain, butlong-term outcome data are unavailable. Follow-upinformation over a median of 2.7 years (0.8-8.6 years)was systematically obtained from 21 outpatientstreated with tricyclic antidepressants after incompleteresponse to antireflux therapy. Initial treatmentproduced at least moderate symptom reduction orremission in 17 subjects (81.0%). Of these, 7 (41.2%)were successfully treated continuously or for symptomrelapses over an average of 2.6 years; 5 (29.4%)discontinued successful treatment after >0.5 yearswith sustained benefits; and 5 (29.4%) eventuallydiscontinued treatment because of side effects or foruncertain reasons (1 having a sustained remission).Low-dose tricyclic antidepressants were considered the most effective long-term chest paintreatment significantly more often than were antirefluxmedications or calcium-channel blockers in this selectedpatient group (P < 0.05 for each). We conclude from this retrospective review that fully threefourths of subjects with functional chest pain whoinitially respond to open-label treatment with low-dosetricyclic antidepressants will use them continuously or for symptom relapses over at least the nexttwo to three years and consider them the most effectivetreatment for their symptoms.

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Authors
  1. Chandra Prakash
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  2. Ray E. Clouse
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Prakash, C., Clouse, R.E. Long-Term Outcome from Tricyclic Antidepressant Treatment of Functional Chest Pain. Dig Dis Sci 44, 2373–2379 (1999). https://doi.org/10.1023/A:1026645914933

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