EFFECT OF D-2-DOPAMINE RECEPTOR ANTAGONIST LEVOSULPIRIDE ON DIABETIC CHOLECYSTOPARESIS - A DOUBLE-BLIND CROSSOVER STUDY

Background: Abnormal gall-bladder motility has been reported in diabet ics. The objective was to evaluate the effect of chronic D-2-dopamine receptor inhibition on gall-bladder emptying in diabetic patients. Met hods: Under double-blind placebo-controlled conditions and according t o a crossover design, patients were randomly assigned to receive eithe r 4 weeks treatment with levosulpiride 25 mg t.d.s. or 4 weeks treatme nt with placebo, with an interval of 15 days. Twenty-three consecutive long-standing, insulin-treated diabetics with autonomic neuropathy we re studied. Measurements: At the beginning of the study and after levo sulpiride or placebo treatment, gall-bladder emptying was measured ult rasonically by evaluating the gall-bladder volume in basal conditions and every 15 min for 90 min after the ingestion of a standard meal. St atistical analysis of the results was performed by means of analysis o f variance. Results: Levosulpiride treatment reduced the basal mean ga ll-bladder volume from 21.6+/-2.3 to 18.6+/-2.3 mL, (P < 0.05). Furthe rmore, the residual gall-bladder volume (9.3+/-1.4 mL) was significant ly reduced compared to the corresponding pre-treatment volume (14.6+/- 1.5 mL (P < 0.05)). In placebo-treated patients, no significant differ ences were observed in gall-bladder volumes before and after treatment . Conclusion: These results show that chronic oral administration of t he D-2-dopamine antagonist levosulpiride has a significant effect on g all-bladder motility in diabetic patients.