Letter to the Editor: Adjunctive low-dose flupentixol-melitracen with lansoprazole rapidly improves functional dyspepsia - implications from a randomized, double-blind trial
Abstract
Functional dyspepsia (FD) is often influenced by psychosocial factors, but high-quality randomized data on the use of neuromodulators is limited. A recent study by Wang et al published in the World Journal of Gastroenterology , which was a single-center, double-blind, placebo-controlled trial, looked at lansoprazole (LPZ) (30 mg daily) combined with low-dose flupentixol-melitracen (FM) (flupentixol 0.5 mg + melitracen 10 mg) in 183 patients with Rome IV FD. This provides important and timely evidence. After two weeks of treatment, the LPZ + FM group showed a significantly higher clinical response rate compared to the LPZ + placebo group (63.0% vs 46.2%; relative risk: 1.42, 95% confidence interval: 1.04-1.93). Patients who received the additional FM had greater and lasting improvements in postprandial distress, quality of life, depressive and anxiety symptoms, and sleep quality. Benefits for Posttraumatic Stress Disorder Scale, Short Form Neck Disability Index, and Patient Health Questionnaire-9 continued through the four-week follow-up. Adverse events were mostly mild (32.6% vs 23.1%), and no serious adverse events occurred. These findings support that short-term, low-dose neuromodulation combined with acid suppression can effectively address both the symptoms and psychosocial factors of FD. Limitations include the study’s single-center design and short treatment duration. Larger, multicenter, and longer trials are needed to confirm long-term effects, optimal dosing, and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 183 participants or records.
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