Korean Journal of Pediatrics 2009;52(5):538-543.
Published online May 15, 2009.
Clinical experience with amitriptyline for management of children with cyclic vomiting syndrome
Ye Jee Shim, Jung-mi Kim, Soonhak Kwon, Byung-Ho Choe
Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
주기성 구토 증후군 소아에서 구토 예방을 위한 amitriptyline의 임상 경험
심예지, 김정미, 권순학, 최병호
경북대학교 의학전문대학원 소아과학교실
Byung-Ho Choe, Email: bhchoi@knu.ac.kr
: To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS).
: Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the natural course without medication, because the frequency of vomiting had recently decreased to less than one episode per year. The eight amitriptyline-treated children were divided into three groups by the therapeutic response: (1) complete remission (CR), with no recurrence of symptoms after treatment; 2) partial remission (PR), in which the frequency of symptoms decreased by almost 50% after treatment; and (3) no response.
: For the eight amitriptyline-treated children, the mean age of symptom onset was 4.7 (0.3-7) yr and mean age at diagnosis was 8.9 (6.0-11.3) yr. The mean number of vomiting episodes was 8.8 (2-25) per year, and the duration of vomiting in each episode ranged from 3 hours to 5 days. CR was achieved in five (62.5%) of the eight amitriptyline-treated children (0.2-0.8 mg/kg/day orally, at night) and PR was achieved in three children (37.5%). Two children relapsed on discontinuation of amitriptyline by their parents decision but showed improvement on remedication. No adverse effects were noted throughout the study period.
: Amitriptyline can be used in long-term prophylaxis for the management of children with CVS aged over 6 yr. However, a large-scale study is needed to ascertain its effects.
Key Words: Vomiting, Amitriptyline, Treatment, Prophylaxis_

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