A controlled trial of cisapride in anorexia nervosa

Abstract

To determine the efficacy of cisapride, 10 mg three times daily, in improving gastric emptying, reducing distress during meals, and facilitating weight gain in anorexia nervosa, we conducted an 8‐week, randomized, double‐blind, placebo‐controlled trial on 29 inpatients. Measures included scintigraphic gastric emptying studies at 0, 2, 4, and 8 weeks; subjective distress during meals measured by visual analogue scales; selfrating of degree of global improvement in symptoms associated with eating at end of study; and weight measured weekly. Gastric emptying improved significantly but equally in both groups over the study period. Yet subjective measures were better in the cisapride group; they rated themselves as more hungry (p = .02) and more improved on the global measure of change in symptoms (p = .02). Even so, the cisapride group did not gain more weight. The correlation between gastric emptying and weight gain was modest (r = .30; p = .11), and between gastric emptying and the subjective measures, virtually absent. © 1995 by John Wiley & Sons, Inc.

Pharmacologic treatment of anorexia nervosa: Where do we go from here?

“…The results, although statistically insignificant, showed improvement in patients taking cisapride in outcome measures of gastric emptying, gastric complaints, and weight gain. A subsequent double-blind, placebocontrolled study conducted by Szmukler et al 20 randomized 29 patients to cisapride or placebo for an 8-week period. Although some subjective measures showed improvement in patients assigned to take cisapride, there was no significant correlation between gastric emptying and either weight gain or subjective measures.…”

Gastric emptying and symptoms of bulimia nervosa: Effect of a prokinetic agent

“…There has been one controlled study of the prokinetic agent cisapride for patients with anorexia nervosa, some with concurrent bulimic symptoms, that suggested at least a marginal effect of cisapride on subjective symptoms [8]. However, a definitive test of the model, particularly of the prediction that increasing gastric emptying would have therapeutic benefit in patients with bulimia nervosa, has not yet been conducted.…”

Current treatment for anorexia nervosa: efficacy, safety, and adherence

“…As previously noted, one RCT found cyproheptadine to be associated with decreased rates of depression and increased improvements in those without bulimic symptoms, but it was associated with decreased efficacy in individuals with bulimic symptoms. 6 Lastly, in an eight-week trial of cisapride versus placebo, cisapride led to improvements in hunger and reductions in overall distress, but it did not prove helpful in increasing weight or ameliorating psychological symptoms 18…”