How sulpiride works
Sulpiride blocks docking sites (receptors) of the neurotransmitter dopamine on the nerve cells, the so-called dopamine-2 and dopamine-3 receptors. The effect achieved is highly dependent on the dosage selected:
At low doses, sulpiride helps against depression, dizziness and nausea (antidepressant, antivertiginous and antiemetic effect). At higher doses, sulpiride has an antipsychotic effect and can therefore help with schizophrenia.
Psychoses such as schizophrenia have several causes. One trigger for numerous mental illnesses appears to be an imbalance of messenger substances (neurotransmitters) in the brain. This primarily refers to changes in the distribution of dopamine, noradrenaline and serotonin. These messenger substances are used to transmit signals between nerve cells and are therefore involved in the development of moods such as excitement or listlessness.
Absorption, breakdown and excretion
After ingestion by mouth, the active ingredient is absorbed slowly and incompletely from the intestine into the blood. It is hardly metabolized in the body, but is excreted almost unchanged, mainly via the kidneys in the urine. After about eight hours, the level of the active substance in the blood has already fallen by half again.
When is sulpiride used?
Sulpiride is used to treat acute or chronic schizophrenia in adults and children as well as dizziness (such as Meniere’s disease). It is also used when the administration of other antidepressants for a depressive illness has been unsuccessful.
How sulpiride is used
The patient usually receives the active substance sulpiride in oral form, either as a tablet or juice. Tablets are swallowed whole with sufficient liquid. If necessary, sulpiride can also be injected into a muscle as a solution for injection.
This maintenance dose for schizophrenia patients is 300 to a maximum of 1000 milligrams of sulpride per day (divided into several individual doses). If the mental disorders are particularly severe, the doctor can increase the dose to a maximum of 1600 milligrams per day.
The maintenance dose for antidepressant therapy and dizziness in adults is 150 to 300 milligrams per day.
Children, the elderly and patients with impaired kidney function receive a lower dose.
What are the side effects of sulpiride?
Common side effects are nausea, headaches, dizziness and tiredness. Accelerated heartbeat (tachycardia) and gastrointestinal complaints such as nausea, vomiting or constipation are also possible.
Sulpiride affects the hormone balance, which can manifest itself in breast pain and menstrual cramps. In men, sexual desire (libido) and potency may decrease.
Sedentary behavior, motor restlessness and other so-called extrapyramidal motor disorders are movement disorders that occur as a typical side effect of antipsychotics, among other things. However, they are less common with sulpiride than with other representatives of this drug group.
If you suffer from severe side effects or unmentioned symptoms, please consult your doctor.
What should I bear in mind when using sulpiride?
Contraindications
Sulpiride must not be used if you are allergic to the active substance or other benzamides. In addition, the medicine must not be used in the following cases
- epileptic seizures in the past
- pheochromocytoma (hormone-producing tumor of the adrenal medulla)
- organic brain diseases associated with states of excitation
- Parkinson’s disease
- certain forms of psychosis (such as manifest psychosis)
- Hyperprolactinemia (excessive production of the hormone prolactin)
Interactions
For example, sulpiride enhances the sedative effect of central depressant drugs (such as sleeping pills or tranquillizers). In combination with CNS-stimulating agents, on the other hand, it can trigger increased restlessness, nervousness and anxiety.
Sulpiride can weaken the effect of blood pressure-lowering drugs (antihypertensives), which can lead to a dangerous rise in blood pressure (blood pressure crisis).
Medicines that affect cardiac conduction should not be used together with sulpiride. Such drugs include beta-blockers, glucocorticoids (“cortisone”) and laxatives.
The simultaneous consumption of sulpiride with alcohol should be avoided due to unpredictable side effects.
Ability to drive and operate machinery
Because sulpiride can trigger central nervous disorders such as dizziness or drowsiness, patients should not operate heavy machinery or actively participate in road traffic during the discontinuation phase.
Pregnancy and lactation
Only limited data are available on the use of sulpiride during pregnancy. It is known that the active substance can cross the placental barrier. In addition, like all antipsychotics, it can cause side effects in the newborn when taken in the last trimester of pregnancy – there are reports of movement disorders, withdrawal symptoms, agitation and problems with food intake.
Sulpiride should therefore only be used in pregnant women after a strict risk-benefit assessment by the doctor.
How to obtain medication with sulpiride
Sulpiride is available on prescription in Germany, Austria and Switzerland in all dosages and pharmaceutical forms.
