[L-sulpiride in the treatment of somatoform disturbances: a double-blind study with racemic sulpiride].

Thirty out-patients, age ranging from 22 to 64 years (mean 49.20 +/- 1.71 SE) diagnosed according to DSM III-R, were studied to evaluate clinical efficacy and tolerability of L-sulpiride (L-SLP) vs racemic sulpiride (SLP) in the treatment of somatoform disorders. After one week of placebo treatment, not responders were treated under double blind conditions with L-SLP (150 mg po/die) (group 1) or with SLP (300 mg po/die) (group 2) for three weeks. A placebo week followed the treatment. Clinical picture and side-effects were evaluated at the beginning of the study and then weekly using the Lipman scale for somatoform disorders (SCL), the Hamilton rating scale for anxiety (HRS-A), the EPSE for extrapyramidal side-effects and a check list for anticholinergic side-effects (ACS). Haematochemical routine, ECG and EEG were controlled at the beginning and at the end of the study. All patients showed a significant improvement (p less than 0.01 for group 1, p less than 0.05 for group 2) at the SCL from the first week of treatment. Patients treated with L-SLP showed a significant improvement (p less than 0.01) of HRS-A since the first week of treatment, while group 2 showed it since the second week. Extrapyramidal and anticholinergic side-effects were more frequent in group 2. This study seems to confirm the useful use of L-SLP in somatoform disorders; clinical and tolerability data point out that this isomer is more potent than the racemic compound, with less side-effects.