Buspirone benefits severe bloating but not postprandial fullness in gastroparesis

It is already known that gastroparesis patients and those with related disorders have early satiety, postprandial fullness and bloating. To improve fundic accommodation, Buspirone, a 5-HT1 receptor agonist, may be used.

Considering this background, in the present study, researchers determined whether Buspirone improves early satiety and postprandial fullness in gastroparesis patients.

The study included patients presenting with symptoms of gastroparesis and moderate-to-severe symptoms of fullness. 10 mg of Buspirone was given orally, while the placebo thrice daily. The primary outcome was a change in the ES/PPF from baseline to 4 weeks.

The key results of this study are:

• There were a total of 96 patients, with 92 % female.
• Forty-seven were randomised to Buspirone were 49 to placebo.
• 50% had delayed gastric emptying, and 39% were diabetic.
• There was no between-groups difference in the 4-week ES/PPF primary outcome.
• Buspirone performed better compared to placebo in patients with a history of severe-to-very severe bloating at baseline compared to patients with none to moderate.
• For those with GCSI symptoms, only bloating improved with Buspirone vs placebo.

Concluding further, they said those with a history of moderate-to-severe early satiety/postprandial fullness and other symptoms of gastroparesis did not benefit from buspirone treatment to improve the ES/PPF primary outcome compared with placebo.

They also added that Buspirone has benefits in patients with more severe bloating.

Further reading:

Parkman HP, Yates KP, Sarosiek I, Bulat RS, Abell TL, Koch KL, Kuo B, Grover M, Farrugia G, Silver P, Abdullah A, Maurer AH, Malik Z, Miriel LA, Tonascia J, Hamilton F, Pasricha PJ, McCallum RW; NIDDK Gastroparesis Clinical Research Consortium. Buspirone for early satiety and symptoms of gastroparesis: A multi-centre, randomised, placebo-controlled, double-masked trial (BESST). Aliment Pharmacol Ther. 2023 Jun;57(11):1272-1289. doi: 10.1111/apt.17479.