Effect of the combinations atropine + cyproheptadine and atropine + carbenoxolone in duodenal ulcer therapy.

Prospective randomized studies were carried out in 136 endoscopically verified duodenal ulcer patients to evaluate the healing effects of the following four-week courses of treatment: placebo, atropine (3 X 0.66 mg), carbenoxolone (3 X 100-3 X 50 mg), atropine + cyproheptadine (3 X 4 mg), atropine + carbenoxolone. Antacid powder was also supplied for relief of symptoms as required. Ulcer healing (incidence and planimetrically calculated surface), changes in complaints, antacid consumption and subjective and objective side-effects were evaluated during each type of treatment. The effectiveness of the different treatments were compared according to these points. The results showed: (i) that atropine, atropine + cyproheptadine and carbenoxolone all had good ulcer healing effects (75%, 74%, 62% respectively), according to incidence; (ii) that the atropine + carbenoxolone combination did not have a better healing effect (44%) than placebo (41%); (iii) that there were no significant differences among the planimetrically calculated ulcer healing effects during the different types of treatment; (iv) that the earliest diminution in complaints the greatest increase in body weight were found in the atropine + cyproheptadine group; (v) that there were no objective side-effects during the four-week treatment periods; and (vi) that definite subjective side-effects were observable only in the two atropine-treated groups. The findings led to the conclusion that the atropine + cyproheptadine combination is of value for the treatment of duodenal ulcer, while the atropine + carbenoxolone combination presents no practical advantages.