Sulpiride

Trade names: Sulpirid, Modal, Betamax, Depral, Dogmatil, Noneston, Prosulpin, Eglek, Eglonil.

Atypical neuroleptic with "regulating" effect on the central nervous system. Moderate antipsychotic effects in him combined with a weak antidepressant and even psychostimulating effect.

According to its chemical structure, sulpiride is a substituted benzamide. The same group includes tiaprid and some other psychotropic drugs. By its structure and some pharmacological properties, sulpiride is also close to metoclopramide. All these agents to some extent block dopamine D2 receptors. The blockade of these receptors is associated with the antipsychotic effect of sulpiride, and its antiemetic effect (as in other neuroleptics).

In psychiatric practice, sulpiride is most often used in combination with other antipsychotics and antidepressants in cases of lethargy, inhibition, anergy, including hallucinatory-delusional and affective (mainly depressive) disorders, as well as alcoholic psychoses.

As an activator is used to treat neurotic disorders in schizotypic disorder. As an antidepressant it is used for monotherapy of depressions of various origin.

Sulpiride has a high level of evidentiary efficacy mainly in relation to psychotic disorders.

In addition, it is used in the treatment of migraine, - for the prevention of atypical and complicated forms of vegetative dysfunction.

Antipsychotic effect of sulpiride is manifested in doses of more than 600 mg / day, in smaller doses (up to 600 mg / day) the stimulating and antidepressant effect prevails. Sulpiride has no significant effect on adrenergic, cholinergic, serotonin, histamine, and GABA receptors.

Sulpiride has some properties common to antipsychotics: it has moderate antiserotonin and cataleptogenic action, weakens the stimulating effects of phenamine. It also enhances the effects of opioid analgesics, barbiturates, tranquilizers, neuroleptics, tricyclic antidepressants, antihypertensives [10], antihistamines, clonidine alcohol. The effects of sulpiride and levodopa are mutually weakened. Antacids reduce its bioavailability by 20-40%.

Contrary to the widespread view of sulpiride as an easily tolerated drug, it often (with a risk only slightly lower than haloperidol, but higher than risperidone) causes extrapyramidal disorders; In addition, among all the typical neuroleptics, the risk of hyperprolactinaemia is the most associated with the intake of sulpiride.