Sulpiride is an active ingredient from the benzamide group. It belongs to the so-called atypical neuroleptics, but also has an antidepressant effect. Sulpiride mainly stimulates certain dopamine receptors in the brain (D2 and D3 receptors). In low doses, sulpiride has a stimulating and mood-lifting effect. In higher doses (from about 300-600mg/day) it also has an additional antipsychotic effect.
Fields of application
The drug sulpiride is used to treat depression and schizophrenia. It is considered a reserve drug when other antidepressants have not been able to achieve the desired effect. It is also approved for the treatment of Meniere’s disease. This is a clinical picture with severe dizziness, nausea and vomiting caused by damage to the inner ear.
Dosage
The drug is available in different dosages. It should be taken with sufficient liquid and preferably not after 4 p.m., otherwise sleep disturbances may occur. It can also be taken independently of meals. The individual dose is determined by the treating physician and should be checked for accuracy at certain intervals and adjusted as necessary. The usual maintenance dose for adults is 50-100mg of sulpiride three times a day.
Contraindications
Sulpiride must not be used for Parkinson’s disease, manic psychosis, epilepsy or other spasms, or Alzheimer’s dementia. Since stimulation of the dopamine receptors can lead to an increased release of the hormone prolactin, Sulpiride must not be used in patients who already have elevated prolactin levels in their blood (hyperprolactinemia). For this reason, therapy with sulpiride is also not recommended for malignant diseases, such as certain tumor entities that react sensitively to the hormone prolactin.
The drug must also not be used if the patient is intolerant to an ingredient contained in sulpiride or if there are acute symptoms of poisoning with painkillers (opioids), alcohol or sleeping pills. In certain patients, therapy with sulpiride is not generally contraindicated, but the prescription of the drug should only be made after thorough examination by the treating physician. This applies to patients with too high or too low blood pressure (hyper- or hypotension), heart failure, angina pectoris, severe liver and kidney dysfunction and young women with irregular menstrual cycles. Special caution is also required in patients with an enlarged prostate, increased intraocular pressure (glaucoma), a tendency to thrombosis or narrowing of the stomach portal (pyloric stenosis).
