Amitriptyline for symptomatic treatment of idiopathic chronic laryngeal irritability

Ann Otol Rhinol Laryngol. 2013 Jan;122(1):20-4. doi: 10.1177/000348941312200105.

Abstract

Objectives: We evaluated the safety and efficacy of amitriptyline hydrochloride in treating idiopathic chronic laryngeal irritability.

Methods: A retrospective chart review identified patients treated with amitriptyline for laryngeal irritability in an academic otolaryngology practice. Subjects who had documented medication compliance and a follow-up evaluation performed within 3 months after initiation of treatment were included. Symptoms, demographic information, and response to therapy were abstracted from the records.

Results: Sixty-six subjects were identified, comprising 48 women and 18 men. The ethnicities were black, 42%; Hispanic, 27%; white, 20%; Asian, 6%; and other or unspecified, 5%. The response to treatment was judged complete in 32% of subjects, partial in 24%, and without improvement in 36%; the remaining 8% were unable to tolerate treatment. Overall, 56.1% of subjects improved (95% confidence limit, 43.3% to 68.3%). No significant differences in response rates were seen based on gender (p = 0.484), age (p = 0.590), or race (p = 0.846). Sedation was reported by 23% of individuals.

Conclusions: We found that more than 50% of subjects who received amitriptyline for chronic laryngeal irritability experienced improvement, and most subjects tolerated this treatment. No differences in efficacy were seen among racial, age, and gender subgroups. A prospective randomized trial of this therapy appears warranted.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Amitriptyline / therapeutic use*
  • Analgesics, Non-Narcotic / therapeutic use
  • Chronic Disease
  • Ethnicity*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Laryngitis / drug therapy*
  • Laryngitis / ethnology
  • Male
  • Massachusetts / epidemiology
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Analgesics, Non-Narcotic
  • Amitriptyline