Psychoses of varying severity have always accompanied humanity. For centuries, it was believed that the devil infiltrated into a sick person, and therefore the "treatment" of this problem was appropriate. Before the creation of antipsychotic drugs, the treatment of mental disorders was carried out with herbal preparations developed on the basis of belladonna, henbane, and opiates. Calcium treatment (intravenous administration) and immersion of the patient in narcotic sleep were also practiced.
The first antipsychotic can be called chlorpromazine, which has been actively used to treat patients with mental disorders since 1953. Currently, the list of antipsychotic antipsychotic drugs has expanded significantly. One of the widely used drugs of this group is Sulpiride. Patient reviews characterize it as a highly effective atypical antipsychotic drug.
Pharmacodynamics of the drug
The antipsychotic effect of Sulpiride is associated with an antidopaminergic effect, that is, in the central nervous system, the drug blocks mainly dopaminergic receptors. Dopamine is an important component of the brain’s “reward system” - it stimulates feelings of pleasure and satisfaction, which, in turn, affects educational and motivational processes. In sufficiently large doses, it is produced in the process of any positive experience (according to the subjective opinion of a person) - the ingestion of delicious food, sex, any pleasant bodily sensations. With an increase in the amount of dopamine in the central nervous system, psychological comfort improves; with a decrease, the symptoms of depression develop.
The action of "Sulpiride" in a dosage exceeding 600 mg (daily volume of the drug) is antipsychotic in nature. If the applied dosage is less than 600 mg, the stimulating and antidepressant effects prevail more. However, the drug has a slight effect on serotonic, histamine, adrenergic receptors.
Medicines - analogues
The medicine “Sulpiride” - an atypical antipsychotic belonging to the group of substituted benzamides - has a fairly large number of medications that are similar in composition and effect. There are drugs that match the ATX code of the 4th level. These are Betamax, Tiaprid, Eglonil. In addition to these, Prosulpin, Eglek, Restful, Vero-Sulpirid, Belupo Sulpirid are in great consumer demand. Reviews of all these medicines from consumers can be both positive and negative. It all depends on the severity of the patient’s state of health, his sensitivity to the main active ingredient - sulpiride, and on the dosage of the drug prescribed for use by the attending physician.
Indications for taking the medication
The antipsychotic “Sulpiride” itself, its analogues have a fairly wide sphere of influence and can be prescribed for use in case of serious enough diseases. They take it in the presence of schizophrenia both in acute stages and in its chronic course. The use of sulpiride-containing antipsychotics in the development of the acute stage of delirium (a mental disorder accompanied by impaired consciousness from dull consciousness to coma) is justified. Quite often, a drug is prescribed for various neurotic disorders and depression, regardless of their origin.
In case of dizziness of various origins, it is recommended to take "Sulpiride" instructions for use. The reviews of patients and health workers characterize the drug well in the treatment of vestibular neuritis, with vertebro-basilar type insufficiency, with otitis media and traumatic brain injuries, with Meniere's disease (an increase in the volume of fluid in the cavity of the inner ear, which puts pressure on the cells responsible for maintaining equilibrium body and its orientation in space).
As an element of complex therapy, “Sulpiride” can be used in therapeutic measures for peptic ulcer and irritable bowel syndrome.
Who should refrain from taking sulpiride-based antipsychotics?
The antipsychotic drug “Sulpiride”, analogues of the drug for the main active substance have a certain list of contraindications. You can not take it to people with hypersensitivity to sulpiride and suffering from hyperprolactinemia (the level of the hormone prolactin in the blood is significantly increased). Accordingly, this medication is not prescribed for prolactin-dependent neoplasms (breast cancer, pituitary prolactinoma , etc.).
Further, “Sulpiride” (indications described above), the instruction prohibits taking with pheochromocytomas (hormone-active tumors of chromaffin cells), manic psychoses and all kinds of affective disorders, with behavioral aggression, epilepsy. The use of sulpiride-containing medicines against acute alcohol intoxication is contraindicated, in case of poisoning with sleeping pills and narcotic analgesics.
The use of the antipsychotic "Sulpiride" is not shown to patients under the age of 18 years and women during lactation.
Possible side effects
The side effects on the antipsychotic itself and Sulpirida analogues are described by patients and medical workers as quite serious, significantly worsening the condition of patients. There is a likelihood of developing hyperprolactinemia in a variety of forms (gynecomastia, dysmenorrhea, frigidity, decreased potency, galactorrhea, weight gain).
Further, the manifestation of extrapyramidal syndrome is possible, which is manifested by pathological disorders of the quantity and quality of spontaneous movements produced by skeletal muscles, a change in muscle tone. However, paralysis is not a symptom confirming the development of extrapyramidal syndrome.
As adverse reactions to Sulpiride, analogues of antipsychotics, tremor, akathisia (inability to stay at rest), dyskinesia, insomnia and drowsiness, anxiety, high irritability, and irritability may appear. Symptoms of malignant antipsychotic syndrome, characterized by vegetative abnormalities, pallor of the skin, hyperthermia, may appear.
Side effects from the gastrointestinal tract may include sensations of dryness in the oral cavity, the development of heartburn, the appearance of nausea, vomiting, constipation. Possible activation of hepatic transaminases and alkaline phosphatase.
The cardiovascular system can respond to the use of Sulpiride by increasing blood pressure (rarely - lowering blood pressure, dizziness), increased heart rate, and an increase in the QT interval. It is very rare, but one can hear that regarding the drug Sulpiride, reviews of doctors indicate the development of arrhythmias such as torsadedepointes.
Allergic manifestations in the form of a skin rash, itching, eczematous rashes are possible. Sometimes you can hear about a violation of visual acuity.
Dosage regimen and application schedule
According to the instructions for the use of the medication, usually for adult patients, depending on the disease, a dose of 100-300 mg per day is prescribed (divided into 2-3 doses). The oral solution is prescribed in a different dosage: 100-800 mg per day for intramuscular injection (before use, it is necessary to shake). The maximum allowable dose for an adult is 1.6 g.
If there is a need for the appointment of “Sulpiride” for children under 18 years of age, then the dosage should be calculated taking into account the weight based on 5 mg per kilogram of weight.
If the patient has a state of psychosis in the acute or chronic stage, therapy usually begins with an intramuscular injection of the drug (400-800 mg per day). In most cases, the treatment period is at least 2 weeks. As soon as the patient’s state of health allows, they switch from intramuscular administration to taking “Sulpiride” inside in the form of tablets. Neuroleptic "Sulpiride" reviews of patients characterize as an effective medication. The duration of the course of therapy can be determined and changed only by the attending physician.
Excess dose
There are no specific symptoms indicating the fact that the dose is exceeded above the maximum permissible. Typically, in such situations, there is an increase in blood pressure, visual impairment. Perhaps the development of a sedative effect (suppression of consciousness provoked by drugs, sedative effect, and with a further increase in dose - sleeping pills). In most cases, as a consequence of using the Sulpirid medication, patient reviews indicate the appearance of nausea, dry mouth, increased sweating, and vomiting. In rare cases, extrapyramidal symptoms develop, in male patients gynecomastia (enlargement of the mammary gland) may occur. Very rarely speak of pronounced Parkinsonism, coma.
Since there is no selective antidote for Sulpiride, symptomatic treatment is recommended depending on the patient's condition. In some cases, central anticholinergic drugs are used.
What to pay special attention to?
Absolutely all drugs of the antipsychotic group (including Betamax, Vero-Sulpiride, Prosulpin, Sulpiride Belupo, Eglonil, Sulpiride sulpiride-containing preparations) are forbidden to take expert reviews and instructions on the background of alcohol-containing drinks. For patients with epilepsy, it is recommended to conduct clinical and electrophysiological studies in advance , since sulpiride lowers the threshold for convulsive activity. If the medication is used in parallel with drugs that increase the risk of developing ventricular arrhythmias, such patients need regular monitoring of the electrocardiogram. The increase in the QT interval is dose dependent.
If symptoms of hyperthermia (a fact indicating the development of a malignant antipsychotic syndrome) appeared against the background of Sulpiride treatment, the use of the drug should be abandoned.
Sudden cessation of Sulpiride therapy can trigger withdrawal symptoms. The presence of maltitol in the preparation makes its use impossible for people suffering from fructose intolerance.
Throughout the treatment period, one must be careful about driving and performing work that requires a quick psychomotor reaction and a high concentration of attention.
Sulpiride-containing medicines and pregnancy
Women who took Sulpiride during pregnancy leave reviews in the majority of positive directions. The maximum allowable dose for pregnant women at 200 mg per day did not provoke a teratogenic effect (deviations in embryonic development). Relatively large doses of the drug for expectant mothers information is missing. There is also no data on the potential effect of antipsychotic drugs on the development of the baby's brain.
In general, healthcare providers prefer not to use Sulpiride for the treatment of pregnant women, unless the positive effect for the woman prevails over the potential risk to the fetus. In such cases, “Sulpiride” instruction (reviews of health workers confirm) recommends that it be prescribed at the lowest possible dosage and, if possible, reduce the treatment period to a minimum.
In children born to women who took sulpiride-containing medicines during pregnancy, gastrointestinal symptoms (bloating, etc.) are occasionally observed, associated with the atropine-like effect of antipsychotics. Sometimes you can hear about extrapyramidal syndrome. During breastfeeding, the reception of "Sulpiride" is contraindicated.
The opinion of patients about "Sulpiride"
The bulk of patients about the drug "Sulpiride" reviews leaves a positive orientation. The antipsychotic is quite effective and justifies the claimed characteristics. People taking Sulpiride or its analogues for mental symptoms during peptic ulcer of the stomach or duodenum report a decrease in the intensity of abdominal pain and an improvement in the general condition.
Small amounts of medication (from 50 to 300 mg during the day) are often prescribed for admission when patients complain of frequent dizziness that occurs for a variety of reasons. The bulk of these patients were satisfied with the results of treatment.
Large doses of Sulpiride (more than 600 mg per day), according to medical professionals, had an effective antipsychotic effect on patients. Doses of less than 600 mg, according to both doctors and patients, exerted a stimulating and antidepressant effect.
There is a group of patients who responded to Sulpiride in a negative way. Individuals developed nausea, agitation, dizziness. Negative symptoms disappeared after discontinuation of Sulpiride.