Sulpiride, sold under the brand name Dogmatil among others, is an atypical antipsychotic (although some texts have referred to it as a typical antipsychotic) medication of the benzamide class which is used mainly in the treatment of psychosis associated with schizophrenia and major depressive disorder, and sometimes used in low dosage to treat anxiety and mild depression. Sulpiride is commonly used in Asia, Central America, Europe, South Africa and South America. Levosulpiride is its purified levo-isomer and is sold in India for similar purpose. It is not approved in the United States, Canada, or Australia. The drug is chemically and clinically similar to amisulpride.
Sulpiride's primary use in medicine is in the management of the symptoms of schizophrenia. It has been used as both a monotherapy and adjunctive therapy (in case of treatment-resistance) in schizophrenia. It has also been used in the treatment of dysthymia. There is evidence, although low quality, that Sulpiride could accelerate antidepressant response in patients with major depressive disorder. There is also evidence of its efficacy in treating panic disorder. Sulpiride is indicated for the treatment of vertigo in some countries. In Japan, Sulpiride is both approved as a treatment for schizophrenia and for major depressive disorder (low dose).
Contraindications
Hypersensitivity to sulpiride
Pre-existing breast cancer or other prolactin-dependent tumors
Phaeochromocytoma
Intoxication with other centrally-active drugs
Concomitant use of levodopa
Acute porphyria
Comatose state or CNS depression
Bone-marrow suppression
Cautions
Pre-existing Parkinson's disease
Patients under 18 years of age (insufficient clinical data)
Pre-existing severe heart disease/bradycardia, or hypokalemia (predisposing to long QT syndrome and severe arrhythmias)
Patients with pre-existing epilepsy. Anticonvulsant therapy should be maintained
Lithium use — increased risk of neurological side effects of both drugs
Pregnancy: Animal studies did not reveal any embryotoxicity or fetotoxicity, nor did limited human experience.
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Extrapyramidal symptoms (EPS) are symptoms that are archetypically associated with the extrapyramidal system of the brain's cerebral cortex. When such symptoms are caused by medications or other drugs, they are also known as extrapyramidal side effects (EPSE). The symptoms can be acute (short-term) or chronic (long-term). They include movement dysfunction such as dystonia (continuous spasms and muscle contractions), akathisia (may manifest as motor restlessness), parkinsonism characteristic symptoms such as rigidity, bradykinesia (slowness of movement), tremor, and tardive dyskinesia (irregular, jerky movements).
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Hyperprolactinaemia is the presence of abnormally high levels of prolactin in the blood. Normal levels average to about 13 ng/mL in women, and 5 ng/mL in men, with an upper normal limit of serum prolactin levels being 15-25 ng/mL for both. When the fasting levels of prolactin in blood exceed this upper limit, hyperprolactinemia is indicated. Prolactin (PRL) is a peptide hormone produced by lactotroph cells in the anterior pituitary gland. PRL is involved in lactation after pregnancy and plays a vital role in breast development.
The influence of chronic dietary lithium administration was evaluated on dopamine receptor supersensitivity in the rat corpus striatum. Supersensitivity was induced with either unilateral destruction of dopamine-containing fibers in the nigrostriatal pathw ...
To investigate whether the reversible MAO-B inhibitor and sodium channel blocker safinamide impairs glutamate release under parkinsonian conditions in vivo, and this effect is dependent on MAO-B inhibition, safinamide (and rasagiline as a comparator) were ...
PERGAMON-ELSEVIER SCIENCE LTD2020
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Besides the main cortical inputs to the basal ganglia, via the corticostriatal projection, there is another input via the corticosubthalamic projection (CSTP), terminating in the subthalamic nucleus (STN). The present study investigated and compared the CS ...