Comparative effects of levosulpiride and cisapride on gastric emptying and symptoms in patients with functional dyspepsia and gastroparesis

Abstract

INTRODUCTIONProkinetic drugs have been extensively tested in the treatment of functional dyspepsia. This is because gastrointestinal motor abnormalities and, in particular, delayed gastric emptying have been frequently reported in patients suffering from this common syndrome. 1±6These abnormalities are regarded as a likely source of symptoms even if no clear cause±effect relationship between severity of symptoms and degree of delay in gastric emptying has been proven to date.7 Among prokinetic drugs, several placebo-controlled trials have provided evidence on the ef®cacy of cisapride and dopamine receptor antagonists such as metoclopramide, domperidone, and recently levosulpiride in the treatment of functional dyspepsia. 8±28 Metoclopramide, domperidone and levosulpiride have both antiemetic and prokinetic properties because they antagonize dopamine receptors in the central nervous system as SUMMARY Background: The ef®cacy of several prokinetic drugs on dyspeptic symptoms and on gastric emptying rates are well-established in patients with functional dyspepsia, but formal studies comparing different prokinetic drugs are lacking. Aim: To compare the effects of chronic oral administration of cisapride and levosulpiride in patients with functional dyspepsia and delayed gastric emptying. Methods: In a double-blind crossover comparison, the effects of a 4-week administration of levosulpiride (25 mg t.d.s.) and cisapride (10 mg t.d.s.) on the gastric emptying rate and on symptoms were evaluated in 30 dyspeptic patients with functional gastroparesis. At the beginning of the study and after levosulpiride or cisapride treatment, the gastric emptying time of a standard meal was measured by 13 C-octanoic acid

Efficacy and Tolerability of Levosulipride, Domperidone and Metoclopramide in Patients with Non-Ulcer Functional Dyspepsia: A Comparative Analysis

“…Over all common ADRs are cited in [Table/ Fig-1], the highest number of ADR were reported from Metoclopramide treatment group. The baseline and final mean (SD) serum biochemistry parameters of all the patients in respective groups defined in [ The reported studies in favor of prokinetic have shown statistically significant cure rates [19,20]. In a previous double-blind crossover comparison performed by Mansi et al, Levosulpiride was effective in reducing gastric emptying time and improving symptoms in patients with functional dyspepsia [20].…”

“…The antidepressive properties of Levosulpiride might bring about a favorable effect; i.e., antidepressive agents and prokinetic agents may act synergistically [20,29].…”

Prokinetics in the Management of Functional Gastrointestinal Disorders

“…Levosulpiride, a DA2 antagonist in development, has been shown to accelerate gastric emptying in diabetics and to improve glycemic control over a 6-month period. 15 Levosulpiride also appeared effective in dyspepsia, 16,17 perhaps via acceleration of gastric emptying. 17 …”

“…15 Levosulpiride also appeared effective in dyspepsia, 16,17 perhaps via acceleration of gastric emptying. 17 …”

Gastroparesis: Current diagnostic challenges and management considerations

“…(b) Sulpiride is a dopamine blocker used for psychiatric disorders. Initial studies have shown that oral levosulpiride is superior to placebo [81] , and may be as effective as cisapride in relieving nausea and vomiting in patients with gastroparesis [82,83] . Although this drug is not new, further studies are of interest to see whether it deserves a more established position for these gastrointestinal indications.…”