From Cheong K et al. Low dose imipramine for refractory functional dyspepsia: a randomised double blind placebo controlled trial. Lancet Gastroenterology Hepatol. Oct 22 2018.
Heartburn is a miserable and very common symptom. It can be treated with antacids such as Peptac and Gaviscon and drugs such as Ranitidine and Omeprazole or Lansoprazole. Domperidone, which increases gut motility can be used short term. But sometimes these don’t work.
Imipramine is an old anti depressant drug which was used in this recent drug trial for heartburn that had not responded to Esomeprazole and Domperidone.
107 patients entered the trial. The treatment arms were placebo or imipramine 25mg at night for two weeks, then 50mg a night for a total of 12 weeks.
In the Imipramine arm 63% of patients got a good reduction in symptom score compared to placebo’s 36.5%.
There was a higher rate of stopping the Imipramine, 18% versus 8% for the placebo. The side effects were dry mouth, constipation, drowsiness, insomnia, palpitations and blurred vision.
My comment: The re use of this old drug will be very helpful for patients who have run out of options for their heartburn. Many patients get an excellent effect when they go on a low carb diet too. The side effects of this are: slim down, lose belly fat, feel more energetic, clearer skin and for diabetics a great improvement in blood sugar control.