BMA Concise Guide to Medicine & Drugs

Amisulpride/Sulpiride

Brand names [amisulpride] Dolmatil, Solian; [sulpiride] Sulpor

Used in the following combined preparations None

QUICK REFERENCE

Drug group Antipsychotic drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Amisulpride and sulpiride are anti-psychotic drugs used to treat acute and chronic schizophrenia, in which there are “positive” symptoms such as delusions, hallucinations, and thought disorders, and/or “negative” symptoms such as emotional and social withdrawal. Patients who have mainly positive symptoms are treated with higher doses; and patients with mainly negative symptoms are treated with lower doses. Sulpiride has also been used in the treatment of Tourette’s syndrome.

An advantage of amisulpride, a so-called atypical antipsychotic drug, is that it is less likely than the older antipsychotic drugs to cause parkinsonism or tardive dyskinesia.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, liquid.

Frequency and timing of doses 1–2 x daily (doses of up to 300mg of amisulpride may be 1 x daily).

Dosage range Amisulpride 50–300mg daily (mainly negative symptoms); 400–1,200mg daily (mainly positive symptoms). Sulpiride 400–800mg daily (mainly negative symptoms); 400–2,400mg daily (mainly positive symptoms).

Onset of effect 1 hour.

Duration of action 12–24 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next dose.

Stopping the drug Do not stop taking the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause drowsiness and low blood pressure. Notify your doctor immediately.

POSSIBLE ADVERSE EFFECTS

Most of the side effects of antipsychotic drugs such as amisulpride and sulpiride are mild. Insominia is the most common problem, although drowsiness and anxiety or agitation are also fairly common. More rarely, there may be weight gain, nausea, or vomiting. Consult your doctor if any of these symptoms become severe. Other rare side effects include breast swelling; parkinsonism; loss of libido; and, in women, menstrual irregularities. Consult your doctor if you experience any of these symptoms.

INTERACTIONS

Amiodarone, disopyramide, diuretics, droperidol, erythromycin, methadone, and sotalol These drugs increase the risk of abnormal heart rhythms when taken with amisulpride or sulpiride.

Antihypertensive drugs Amisulpride and sulpiride may reduce the blood-pressure lowering effect of certain of these drugs.

Central nervous system depressants These drugs may all increase the sedative effects of amisulpride and sulpiride.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have liver or kidney problems.

· You have heart problems or hypertension.

· You have epilepsy.

· You have Parkinson’s disease.

· You have a pituitary tumour or breast cancer.

· You have phaeochromocytoma.

· You have had blood problems.

· You are taking other medicines.

Pregnancy Short-term nervous system problems may occur in babies when the drug is taken in the third trimester. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Not recommended.

Over 60 Reduced dose may be necessary.

Driving and hazardous work Avoid such activities until you have learned how amisulpride and sulpiride affect you; the drugs can slow reaction times and may occasionally cause drowsiness or loss of concentration.

Alcohol Avoid. Alcohol increases the sedative effects of these drugs.

PROLONGED USE

An adverse effect called tardive dyskinesia, in which there are involuntary movements of the tongue and face, may rarely occur during long-term use.