Sulpiride is an antipsychotic or neuroleptic drug. It has a benzodiazepine structure and is classified as a specific dopamine receptor antagonist. In turn, dopamine is a vital neurotransmitter in our nervous system because it regulates many of our bodies’ responses.
It’s especially important regarding motor functions, as it helps to regulate body movements. It also acts in emotional responses and sensations, as well as in cognition and behavior, among other areas.
High levels of dopamine are associated with mental illnesses such as schizophrenia and psychosis. For this reason, many of the antipsychotic drugs are antidopaminergic and block the effects of this neurotransmitter.
Doctors have shown sulpiride to be a highly effective drug in a number of psychological disorders. It’s effective in psychosomatic syndromes, senile dementia, gastrointestinal somatizations, and vertigo, among others.
What’s sulpiride used for?
The therapeutic indications listed in this drug’s printed information are the following:
- Treatment of depressive disorders with psychotic symptoms in combination with antidepressants. They’ll be prescribed if antidepressants alone have proved ineffective.
- Other severe forms of depression resistant to antidepressants.
- Treatment of acute and chronic psychosis.
- Treatment of vertigo in cases where there’s no response to the usual treatment for vertigo.
As we’ve seen, sulpiride is an antipsychotic drug but it isn’t only used in mental disorders; it’s also useful in neurological diseases. In the case of vertigo, this drug has also proven to be effective.
Vertigo affects approximately 23% of the general population, and many people go see their doctor due to this condition. Generally, its prevalence tends to increase with age.
It’s a hallucinatory sensation of movement produced by an alteration of spatial orientation. Its origin is usually in the structures of the inner ear. Alternatively, it can originate in the vestibular pathway of the central nervous system.
Mechanism of action
Sulpiride acts as a specific antagonist of dopamine D2 and D3 receptors. Its effect depends mainly on the dose administered, which a physician should always prescribe and control.
At low doses, it has an effect on negative psychotic symptoms, but hardly any effect on positive symptoms. At higher doses, it improves positive symptoms in patients with acute or chronic psychosis. Very high doses of sulpiride may have sedative effects.
As for its antivertiginous action, sulpiride blocks D2 receptors in the chemoreceptor trigger area and, thus, inhibits vomiting. It also acts on the regulatory mechanisms of balance and sense of spatial orientation.
It exerts a potent vestibular suppressive effect and is especially useful in the symptomatic treatment of the nausea and vomiting that may accompany vertigo and motion sickness. Patients usually take it orally, but, in severe cases, doctors can also administer it intramuscularly.
The most common side effects of sulpiride treatment are:
- Sedation or somnolence.
- Extrapyramidal disorder.
- Symptoms of Parkinson’s disease.
- Increased liver enzymes.
- Chest pain.
- Weight gain.
It’s important to notify the doctor of any adverse reactions experienced during treatment. Therefore, to avoid interactions, its administration shouldn’t be combined with antiparkinsonian or antiarrhythmic drugs.
Likewise, in order to avoid unwanted effects, the patient should always respect the dosage and duration of treatment indicated by the specialist.
In case of an overdose, there’s no specific antidote for sulpiride. Treatment would be symptomatic, especially the monitoring of cardiac functions. In case of extrapyramidal symptoms, specialists should administer anticholinergic drugs.