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

Background: The efficacy of several prokinetic drugs on dyspeptic symptoms and on gastric emptying rates are well-established in patients with functio nal 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 em ptying. Methods: In a double-blind crossover comparison, the effects of a 4-week ad ministration of levosulpiride (25 mg t.d.s.) and cisapride (10 mg t.d.s.) o n the gastric emptying rate and on symptoms were evaluated in 30 dyspeptic patients with functional gastroparesis. At the beginning of the study and a fter levosulpiride or cisapride treatment, the gastric emptying time of a s tandard meal was measured by C-13-octanoic acid breath test. Gastrointestin al symptom scores were also evaluated. Results: The efficacy of levosulpiride was similar to that of cisapride in significantly shortening (P < 0.001) the t(1/2) of gastric emptying. No sig nificant differences were observed between the two treatments with regards to improvements in total symptom scores. However, levosulpiride was signifi cantly more effective (P < 0.01) than cisapride in improving the impact of symptoms on the patients' every-day activities and in improving individual symptoms such as nausea, vomiting and early postprandial satiety. Conclusions: The efficacy of levosulpiride and cisapride in reducing gastri c emptying times with no relevant side-effects is similar. The impact of sy mptoms on patients' everyday activities and the improvement of some symptom s such as nausea, vomiting and early satiety was more evident with levosulp iride than cisapride.