Abstract
The effects of domperidone, a peripherally acting dopamine antagonist, were compared with those of placebo in a double-blind randomized study in 16 patients with idiopathic gastric stasis, chronic symptoms of “nonulcer dyspepsia” (including nausea, vomiting, and abdominal pain), and altered gastroduodenal motility. Patients received either domperidone or placebo orally (20 mg before meals and at bedtime) for six weeks. Symptoms were assessed by daily diaries kept by the patients for two weeks while receiving no medication for their gastrointestinal complaints (baseline), and throughout the six-week treatment phase. Studies of gastric emptying of a radiolabeled solid-phase meal were performed at baseline and six weeks after treatment. All patients had delayed gastric emptying at baseline, defined as a half-emptying time of more than mean +1 sd (from studies of normal controls). An 18- to 24-hr recording of gastroduodenal motor function during fasting was also performed at baseline and after six weeks of either domperidone or placebo treatment. After six weeks of treatment, the symptom scores significantly improved in the domperidone group (P<0.05), but not in the placebo group. Gastroduodenal motor activity was unchanged from baseline recordings after six weeks. Solid-phase gastric emptying also showed no improvement in either the domperidone or placebo group of patients. Although domperidone therapy had no significant effect on motility, it appears to be an effective drug for the treatment of the symptoms of nonulcer dyspepsia.
Similar content being viewed by others
References
You CH, Chey WY, Lee KY, Menguy R, Bortoff A: Gastric and small intestinal myoelectric dysrhythmia associated with chronic intractable nausea and vomiting. Ann Intern Med 95:449–451, 1981
Rees WDW, Miller LJ, Malagelada J-R: Dyspepsia, antral motor dysfunction, and gastric stasis of solids. Gastroenterology 78:360–365, 1980
Mathias JR, Finelli DS: Functional diseases of the small intestine.In Functional Disorders of the Gastrointestinal Tract. S Cohen and R Soloway (eds). New York, Churchill Livingstone, 1987, pp 39–58
Camilleri M, Brown ML, Malagelada J-R: Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroenterology 91:94–99, 1986
Vantrappen G, Janssens J, Coremans G, Jian R: Gastrointestinal motility disorders. Dig Dis Sci 31:5S-25S, 1986
Malagelada J-R, Stanghellini V: Manometric evaluation of functional upper gut symptoms. Gastroenterology 88:1223–1231, 1985
McCallum RW: Review of the current status of prokinetic agents in gastroenterology. Am J Gastroenterol 80:1008–1016, 1985
Valenzuela JE, Dooley CP: Dopamine antagonists in the upper gastrointestinal tract. Scand J Gastroenterol 96 (suppl):127–136, 1984
De Schepper A, Wollaert F, Reyntjjens A: Effects of oral domperidone on gastric emptying and motility: A doubleblind comparison with placebo and metoclopramide. Arzneimittelforschung 28(II):1196–1199, 1978
Perkel MS, Moore C, Hersh T, Davidson ED: Metoclopramide therapy in patients with delayed gastric emptying. Dig Dis Sci 24:662–666, 1979
Nagler J, Miskovitz P: Clinical evaluation of domperidone in the treatment of chronic postprandial idiopathic upper gastrointestinal distress. Am J Gastroenterol 76:495–499, 1981
Brogden RN, Carmine AA, Heel RC, Speight TM, Avery GS: Domperidone: A review of its pharmacological activity, pharmacokinetics, and therapeutic efficacy in the symptomatic treatment of chronic dyspepsia and as an antiemetic. Drugs 24:360–400, 1982
Horowitz M, Harding PE, Chatterton BE, Collins PJ, Shearman DJC: Acute and chronic effects of domperidone on gastric emptying in diabetic autonomic neuropathy. Dig Dis Sci 30:1–9, 1985
Schade RR, Dugas MC, Lhotsky DM, Gavaler BS, Van Thiel DH: Effect of metoclopramide on gastric liquid emptying in patients with diabetic gastroparesis. Dig Dis Sci 30:10–15, 1985
Champion MC: Domperidone, a new dopamine antagonist. Can Med Assoc J 135:457–461, 1986
Sninsky CA, Davis RH, Clench MH, Thomas KD, Mathias JR: Effect of lidamidine hydrochloride and loperamide on gastric emptying and transit of the small intestine. A double-blind study. Gastroenterology 90:68–73, 1986
Martin JL, Beck WJ, McDonald AP, Carlson GM, Mathias JR:99mTc-labeled solid-phase meal: A quantitative clinical measurement of human gastric emptying. J Clin Gastroenterol 5:315–319, 1983
Elashoff JD, Ready TJ, Meyer JH: Analysis of gastric emptying data. Gastroenterology 83:1306–1312, 1982
Sninsky CA, Davis RH, Clench MH, Mathias JR: Improving the sensitivity of the gastric emptying test. Dig Dis Sci 29:547, 1984 (abstract)
Mathias JR, Sninsky CA, Millar HD, Clench MH, Davis RH: Development of an improved multi-pressure-sensor probe for recording muscle contraction in human intestine. Dig Dis Sci 30:119–123, 1985
Weisbrodt NW: Motility of the small intestine.In Physiology of the Gastrointestinal Tract, 2nd ed. LR Johnson (ed). New York, Raven Press, 1987, pp 631–663
Chey WY, You CH, Ange DA: Open and double-blind clinical trials of domperidone in patients with unexplained nausea, vomiting, abdominal bloating and early satiety. Gastroenterology 82:1033, 1982 (abstract)
Liernard J, Janssen J, Verhaegen H, Bourgeois E, Willcox R: Oral domperidone (R33812) in the treatment of chronic dyspepsia: A multicenter evaluation. Curr Ther Res 23:529–537, 1978
Davis RH, Sninsky CA, Clench MH, Mathias JR: Effects of domperidone on gastroduodenal motor activity in patients with gastroduodenal dysfunction. Gastroenterology 86:1058, 1984 (abstract)
Loo FD, Palmer DW, Soergel KH, Kalbfleisch JH, Wood CM: Gastric emptying in patients with diabetes mellitus. Gastroenterology 86:485–494, 1984
Horowitz M, Maddox A, Harding PE, Maddern GJ, Chatterton BE, Wishart J, Shearman DJC: Effect of cisapride on gastric and esophageal emptying in insulin-dependent diabetes mellitus. Gastroenterology 92:1899–1907, 1987
Author information
Authors and Affiliations
Additional information
This study was supported partly by the Medical Research Service of the Veterans Administration, Clinical Research Center grant No. RR-82, and Janssen Pharmaceutica, Inc.
Rights and permissions
About this article
Cite this article
Davis, R.H., Clench, M.H. & Mathias, J.R. Effects of domperidone in patients with chronic unexplained upper gastrointestinal symptoms: A double-blind, placebo-controlled study. Digest Dis Sci 33, 1505–1511 (1988). https://doi.org/10.1007/BF01535938
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01535938