Indigestion drug makes headway.

Functional dyspepsia is the diagnosis that doctors often assign to people with chronic indigestion who don't have a stomach ulcer or clear signs of acid-reflux disease. These people have a sense of fullness even though they haven't eaten much, and they have bloating, nausea, and stomach pain that can resemble heartburn. The cause of functional dyspepsia is unclear, and standard medications offer little help.

Researchers report in the Feb. 23 New England Journal of Medicine that a drug called itopride relieves symptoms of functional dyspepsia significantly better than a placebo does.

Physician Gerald Holtmann of the Royal Adelaide Hospital in Australia and his colleagues randomly assigned 554 volunteers with functional dyspepsia to receive one of three dosages of itopride or a similar-looking inert pill.

After 8 weeks, 60 percent of the people getting itopride and 41 percent of those on the placebo reported improvement in their symptoms.

Itopride binds to a protein called the D2 dopamine receptor on cell surfaces. The authors note that stimulation of this receptor enhances the release of the hormone prolactin, and, in their test, prolactin concentrations rose in people getting itopride but not the placebo recipients. Earlier work suggested that prolactin speeds the flow of food through the stomach, possibly relieving functional dyspepsia.--N.S.