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Effect of the low‐affinity, noncompetitive N‐methyl‐ d ‐aspartate receptor antagonist dextromethorphan on visceral perception in healthy volunteers
Author(s) -
Kuiken S. D.,
Lei A.,
Tytgat G. N. J.,
Holman R.,
Boeckxstaens G. E. E.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2002.01358.x
Subject(s) - dextromethorphan , barostat , medicine , distension , dextrorphan , placebo , gastric distension , anesthesia , antagonist , nmda receptor , receptor antagonist , visceral pain , pharmacology , nausea , endocrinology , receptor , nociception , alternative medicine , pathology
Summary Background : The use of N‐methyl‐ d ‐aspartate (NMDA) receptor antagonists may hold promise for the treatment of pain of visceral origin, in particular in conditions characterized by visceral hypersensitivity. Aim : To study the effect of dextromethorphan, a low affinity, non‐competitive NMDA receptor antagonist, on visceral perception in healthy volunteers. Methods : Nine healthy volunteers (5 female, median age 22 years) underwent a gastric barostat study after oral administration of placebo, dextromethorphan 10 mg or dextromethorphan 30 mg, on three separate days in a double‐blind, randomised order. Sensations induced by step‐wise isobaric gastric distension (2 mmHg/2 min) were studied during fasting and 30 min after a meal. In addition, proximal gastric tone was measured during fasting and postprandially. Results : Compared to placebo, dextromethorphan 30 mg significantly increased the distension‐evoked sensation scores for nausea ( P =0.004) and satiation ( P =0.004) during fasting; and for bloating ( P = 0.001), nausea ( P =0.000) and satiation ( P =0.01) 30 min postprandially. Dextromethorphan did not alter pain scores, proximal gastric tone or gastric compliance. Conclusions : Dextromethorphan increases the perception of non‐painful sensations during gastric distension, without altering the perception of pain. Therefore, application of dextromethorphan as a visceral analgesic is questionable. Future studies with more specific NMDA receptor antagonist are warranted.