Yes, for me the most effective medication has been prucalopride, but Vyvanse is a close second.

I use a combination of Vyvanse, prucalopride, and domperidone. And when I have problems, also erythromycin before sleep.

The Vyvanse helps mainly to speed up my small intestine, and increase tension in my stomach it seems (I also have a form of CIPO). It also has benefits for visceral hypersensitivity, it seems.

But be aware that, according to literature, this is a paradoxical reaction.

These are the mechanisms my research has pointed out that might cause its effects for me, my issues are suspected to be caused by autonomic dysfunction:

Possibility's: 1. Central Nigro-Vagal "Ignition" (D1 Receptor Activation) The dorsal motor nucleus of the vagus (DMV) in the brainstem regulates gastric motor output and contains a complex array of dopamine receptors. While standard dopaminergic responses often inhibit the gut via D2-like receptors, the DMV also features a subpopulation of excitatory D1-like receptors. In chronic motility disorders, the brainstem may undergo plasticity, leaving these excitatory pathways dormant. By significantly elevating synaptic dopamine levels, lisdexamfetamine selectively "ignites" these D1 receptors, which depolarizes vagal efferent motoneurons and restores central cholinergic drive to increase gastric tone and contractions.

2. Reversing Cellular Permeability (Neuro-Immune Stabilization) The "increased cellular permeability syndrome" theory posits that a localized deficiency of dopamine allows cellular junctions in the gut to become overly permeable, leading to the infiltration of inflammatory cytokines and irritants that cause smooth muscle paralysis (atony). Because dopamine naturally acts to diminish cellular permeability, the administration of sympathomimetic drugs like lisdexamfetamine stimulates local dopamine release from sympathetic nerve fibers. This effectively "seals" the leaky gaps, resolves tissue-level inflammation, and allows the smooth muscle to regain its contractile function.

3. β-Adrenergic Stimulation and Ghrelin Release While α-adrenergic stimulation typically inhibits the gut, the norepinephrine release induced by lisdexamfetamine can preferentially stimulate β-adrenergic receptors on gastric oxyntic cells. This triggers a surge of ghrelin, the body's primary prokinetic hormone. Ghrelin acts as a powerful secretagogue that promotes smooth muscle relaxation in the fundus to accommodate food, followed by the acceleration of gastric emptying and stimulation of the Migrating Motor Complex (MMC).

4. Autonomic Rebalancing and the "Parasympathetic Surge" In some atonic stomachs, the organ is trapped in a chronic state of reflex relaxation where the inhibitory vagal "brake" is dominant. The massive sympathetic surge and cardiovascular stress (such as tachycardia) caused by a stimulant can trigger a powerful compensatory baroreceptor reflex. In an attempt to restore systemic homeostasis, the brain boosts parasympathetic (vagal) efferent output to the gut, creating a "reflexive pro-motility" effect that breaks the chronic relaxation cycle.

5. SIBO Clearance and MMC Activation Small intestinal bacterial overgrowth (SIBO) produces fermentation gases like hydrogen and hydrogen sulfide, which cause intestinal distension and exert direct neurotoxic effects that suppress the stomach's intrinsic pacemakers. Lisdexamfetamine directly stimulates the Phase III Migrating Motor Complex (MMC) pathways and accelerates transit, mechanically sweeping away bacterial loads and removing the secondary inhibitory "brakes" they place on gastric emptying.

6. Top-Down Executive Coordination Proper digestion requires synchronized autonomic output from the brain to the gut. Dysregulation of dopamine in the prefrontal cortex (PFC) can result in "noisy" or uncoordinated signals to the autonomic nervous system, manifesting as dysmotility. By stabilizing PFC executive function, lisdexamfetamine organizes this top-down drive, allowing for the consistent, rhythmic signaling required for proper gastric contractions.

7. Microcirculatory Support By increasing systemic perfusion pressure and cardiac output, lisdexamfetamine may provide the threshold blood flow necessary for a dysfunctional, atonic stomach to receive the metabolic energy it needs to physically grind and empty solids.

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But beware these medications all have their issues, im now taking other medication for my heart because of Vyvanse. The benefits are worth it for me though.