Nayak S. Letter to the Editor: Adjunctive low-dose flupentixol-melitracen with lansoprazole rapidly improves functional dyspepsia - implications from a randomized, double-blind trial. World J Gastroenterol 2026; 32(37): 120735 [DOI: 10.3748/wjg.120735]
Corresponding Author of This Article
Snehasis Nayak, Department of Student Research Committee, University of Visayas Gullas College of Medicine, Banilad, Cebu 6000, Philippines. snehasisnayak37@gmail.com
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Gastroenterology & Hepatology
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letter
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Nayak S. Letter to the Editor: Adjunctive low-dose flupentixol-melitracen with lansoprazole rapidly improves functional dyspepsia - implications from a randomized, double-blind trial. World J Gastroenterol 2026; 32(37): 120735 [DOI: 10.3748/wjg.120735]
World J Gastroenterol. Oct 7, 2026; 32(37): 120735 Published online Oct 7, 2026. doi: 10.3748/wjg.120735
Letter to the Editor: Adjunctive low-dose flupentixol-melitracen with lansoprazole rapidly improves functional dyspepsia - implications from a randomized, double-blind trial
Snehasis Nayak
Snehasis Nayak, Department of Student Research Committee, University of Visayas Gullas College of Medicine, Cebu 6000, Philippines
Author contributions: Nayak S was responsible for original draft, data curation, investigation, writing of the manuscript.
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Corresponding author: Snehasis Nayak, Department of Student Research Committee, University of Visayas Gullas College of Medicine, Banilad, Cebu 6000, Philippines. snehasisnayak37@gmail.com
Received: March 9, 2026 Revised: May 15, 2026 Accepted: June 24, 2026 Published online: October 7, 2026 Processing time: 179 Days and 0.2 Hours
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 safety. Nonetheless, this study should encourage clinicians and guideline panels to seriously consider adjunctive neuromodulators as a practical, evidence-based option for certain FD patients.
Core Tip: Combining lansoprazole (30 mg daily) with low-dose flupentixol-melitracen can effectively address both the symptoms and psychosocial factors of functional dyspepsia. This commentary discusses the potential role of early gut-brain axis modulation, examines the strengths and limitations of current evidence, highlights regulatory and geographic differences in the use of flupentixol-melitracen, and emphasizes the need for large multicenter studies to identify patients most likely to benefit from this therapeutic approach.
