tropisetron and Anorexia-Nervosa

1. The 5-hydroxytryptamine 3 receptor antagonist, ICS 205-930, has been reported to have potent effects on gastric smooth muscle and to enhance gastric emptying in animals, but findings in man have been inconsistent. 2. This study investigated the effects of ICS 205-930 on gastric emptying of an isotopically labelled semisolid 1168 kJ meal and on antral contractility in patients with primary anorexia nervosa, a condition frequently associated with impaired gastric motor function. 3. Thirteen female patients (age 18-39 years, median 22 years; percentage of ideal body weight 52-90%, median 66%) participated each in two studies, in which 0.15-0.18 mg kg-1 ICS 205-930 or placebo were infused i.v. in crossover, double-blind fashion. Gastric emptying and antral contractility were recorded scintigraphically for 50 min. 4. ICS 205-930 did not affect gastric emptying: the mean percentage of meal remaining in the stomach after 50 min (69.6% +/- 3.2 s.e. mean) was nearly identical to that after placebo (70.7 +/- 3.3%). 5. Amplitude, frequency and propagation velocity of antral contractions differed only little after ICS 205-930 and placebo, respectively. 6. The results show that ICS 205-930 has no effect on the impaired gastric motor activity in primary anorexia nervosa and thus provide further evidence that the compound does not have prominent prokinetic effects in man.

Topics: Adult; Anorexia Nervosa; Blood Pressure; Female; Gastric Emptying; Humans; Indoles; Infusions, Intravenous; Muscle Contraction; Pulse; Pyloric Antrum; Serotonin Antagonists; Tropisetron

We investigated the roles of the vagus nerve and the serotonin3 (5-HT3) receptor in mediating the food intake depression associated with amino acid deficiency. The food intake of sham-operated (sham) rats given an isoleucine-imbalanced (IMB) diet was reduced to < 40% of control basal (BAS) diet intake (P = 0.0009), and pretreatment with the 5-HT3 antagonist tropisetron (Trop) increased IMB intake by twofold over the vehicle (VEH)-treated group (P < or = 0.0001), as we have reported before. However, after subdiaphragmatic vagotomy (VAGX), IMB intake was increased to a level intermediate between the sham-VEH and sham-Trop groups, while administration of Trop did not increase IMB intake over VAGX alone. By the end of day 1, the VAGX-Trop group had eaten only 1 g more of IMB than the VAGX-VEH group (NS). We conclude that 1) the vagus is among the physiological systems involved in the anorectic responses to IMB and 2) intact vagal function is necessary for the full effect of 5-HT3 antagonists in alleviating the anorectic responses to IMB.

Topics: Animals; Anorexia Nervosa; Diet; Eating; Indoles; Isoleucine; Male; Rats; Rats, Sprague-Dawley; Serotonin Antagonists; Tropisetron; Vagotomy