The effects of antidepressant therapy on functional dyspepsia were assessed in a double-blind, randomized controlled trial. Adequate response relief was reported by 40%, 53% and 38% of those given placebo, amitriptyline and escitalopram, respectively. Patients with ulcer-like functional dyspepsia were threefold more likely to report response relief with amitriptyline than placebo. Neither drug affected gastric emptying or meal-induced satiety, but both improved overall quality of life.