Efficacy of buspirone, a fundus-relaxing drug, in patients with functional dyspepsia.
OBJECTIVE
Impaired accommodation and hypersensitivity to gastric distention are believed to be involved in the development of functional dyspepsia (FD). Buspirone, a 5-hydroxytryptamine 1A receptor agonist, relaxes the proximal stomach in healthy individuals. We studied the effects of buspirone on symptoms and mechanisms of FD.


METHODS
We performed a randomized, double-blind, placebo-controlled, crossover study of 17 patients (13 women; mean age, 38.5 ± 2.4 years). The study included 2 treatment periods of 4 weeks each, separated by a 2-week washout period. In the first period, 7 participants were given buspirone (10 mg, 3 times daily for 4 weeks) and 10 were given placebo 15 minutes before meals; patients switched groups for the second period. We assessed meal-related symptoms and severity, along with gastric sensitivity, accommodation, and emptying (by using barostat and breath tests) before and after 4 weeks of treatment.


RESULTS
Buspirone significantly reduced the overall severity of symptoms of dyspepsia (7.5 ± 1.3 vs 11.5 ± 1.2 for placebo; P < .005) and individual symptoms of postprandial fullness, early satiation, and upper abdominal bloating, whereas placebo had no significant effect (all P < .05). Buspirone did not alter the rate of gastric emptying of solids or sensitivity to gastric distention, but it significantly increased gastric accommodation, compared with placebo (229 ± 28 vs 141 ± 32 mL, respectively; P < .05), and delayed gastric emptying of liquids (half-life = 64 ± 5 vs 119 ± 24 minutes, respectively). Adverse events were similar when patients were given buspirone or placebo.


CONCLUSIONS
In patients with FD, 4 weeks of administration of buspirone significantly improved symptoms and gastric accommodation, compared with placebo, whereas gastric emptying of liquids was delayed.
Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. jan.tack@med.kuleuven.ac.be
Jan
J
Tack
Pieter
P
Janssen
Tatsuhiro
T
Masaoka
Ricard
R
Farré
Lukas
L
Van Oudenhove
D000328:Adult; D000368:Aged; D002065:Buspirone / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004415:Dyspepsia / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos / Q000008:administration & dosage; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D010919:Placebos; D002065:Buspirone