Antipsychotics sulpiride

SUCRALFATE ANTIPSYCHOTICS -SULPIRIDE 1 sulpiride levels 1 absorption of sulpiride Give sulpiride at least 2 hours after sucralfate... 

Compared to antipsychotics, there are even fewer studies on the prescribing patterns of antidepressants done in Asian countries. Pi etal. (1985) conducted a survey of psychotropic prescribing practices reported by psychiatrists in 29 medical schools in 9 Asian countries. Daily dose range of tricyclic antidepressants (TCAs) such as amitriptyline, imipramine, and nortriptyline in Asian countries was comparable to the practice in USA. This is despite differences found between Asian and non-Asian populations in the pharmacokinetics of TCAs (Pi et al, 1993). A questionnaire on the practical prescribing approaches in mood disorders administered to 298 Japanese psychiatrists was reported by Oshima et al. (1999). As first-line treatment, the majority of respondents chose newer TCAs or non-TCAs for moderate depression and older TCAs for severe depression. Combination of antidepressants and anxiolytics was preferred in moderate depression, while an antidepressant and antipsychotic combination was common in severe psychotic depression. Surprisingly, sulpiride was the most favored drug for dysthymia. In a naturalistic, prospective follow-up of 95 patients with major depression in Japan, the proportion of patients receiving 125 mg/day or less of imipramine was 69% at one month and 67% at six months (Furukawa et al., 2000). 

Of the antipsychotic drugs prescribed, 72% were typical antipsychotics, which included haloperidol, chlorpromazine, levomepromazine, sulpiride, trifluoperazine, fluphenazine, flupentixol, and bromperidol. Use of typical drugs was associated with longer hospitalization, male gender, and clinical reports of violence or aggression. Atypical drugs only accounted for 28% of antipsychotic drugs... 

Other orthopramides have been shown to be resistant to in vivo hydrolysis. Thus, the gastrokinetic drug cisapride (4.80) was not hydrolyzed after oral administration to dogs and humans [51]. Similarly, sulpiride (4.81), an antidepressant and antipsychotic drug, did not undergo hydrolysis in humans and laboratory animals. These compounds are metabolized by other routes, and hydrolysis of the amide bond, when it occurs at all, is only a minor pathway. 

The conventional antipsychotics have little effect on the negative psychotic symptoms such as autism, stupor and emotional withdrawal. The so-called atypical antipsychotics, or second-generation antipsychotics, like the heterocyclic compound risperidone, the benzamide sulpiride and several diben-zepines of which clozapine is the best known, have a broader spectrum which means that they also have an effect on the negative psychotic symptoms. Most share a common attribute of working on serotonin receptors as well as dopamine receptors. They have a low risk of extrapyramidal side effects. 

Benzamides are heterocyclic neuroleptics. These include the gastroenterologic agents metoclopramide and cisapride, which have antiserotonergic as well as anti-D2 receptor dopaminergic actions and also the antipsychotic agents sulpiride and tiapride. Tachyarrhythmias have resulted in the withdrawal of cisapride from general use. 

Tiapride and sulpiride are neuroleptics of the substituted benzamide class. These selective Dj blockers have weak antipsychotic properties and are not available in the United States, although they are commonly used in Europe for the treatment of tics. In a pair of 6-week controlled trials involving 27 children with TS, at doses ranging from 4 to 6 mg/kg/day, tiapride was superior to placebo and produced a 30%-44% decrease in videotaped tic counts (Eggers et ah, 1988). 

Two other randomly assigned placebo-controlled studies with the antipsychotics, pimozide (Vander-eycken and Pierloot, 1982) and sulpiride (Vander-eycken, 1984) failed to demonstrate any benefit for overall weight gain compared to placebo. 

Area of assessment Clinically sedative antipsychotics, Less sedative antipsychotics, e.g. chlorpromazine, clozapine, e.g. haloperidol, perphenazine, olanzapine pimozide, sulpiride ... 

Antipsychotic drugs with strong sedative clinical effects (e.g. chlorpromazine. clozapine, olanzapine) produce subjective and objective sedation and impair most areas of performance in healthy volunteers, usually at doses far below those typically used in patients. Antipsychotic drugs with little sedative clinical action (e.g. pimozide, sulpiride, amisulpride) produce few subjective and objective effects in healthy... 

Varying degrees with all antipsychotics except olanzapine and clozapine. Most marked with sulpiride... 

Regarding neuroleptic-induced dystonias, it is well known that typical neuroleptics cause catalepsy in rats and movement disorders in man. By contrast, the atypical neuroleptics clozapine and sulpiride have a low propensity to cause movement disorders in man even though they have established antipsychotic effects. These atypical neuroleptics, unlike many of the typical neuroleptics, have a low affinity for sigma receptors which lends support to the hypothesis that the dystonias produced by typical... 

In our model, we have indicated that atypical antipsychotics (12) (sulpiride, metoclopramide, molindone, and Ro 22-1319) differ from classical neuroleptics (tricyclics, butyrophenones, butaclamol, diphenyl-piperidines) by lacking a lipophilic functional group on the basic nitrogen that could extend into the auxiliary binding site identified in our model. The absence of this lipophilic functionality may now be stated to be the characteristic which distinguishes selective D-2 dopamine receptor antagonists from non-selective antagonists. 

It was later found that some effects of dopamine did not involve stimulation of adenylyl cyclase. Particularly, in the pituitary gland, dopamine was found to inhibit prolactin release without stimulating adenylyl cyclase activity and even by inhibiting it (Spano et al., 1978 De Camilli et al., 1979). Moreover, the antipsychotic drug sulpiride blocked the dopamine-induced release of prolactin in the pituitary gland but was unable to antagonize the dopamine response on adenylyl cyclase activity in the striatum (Trabucchi et al., 1975). These observations led to the hypothesis that the dopamine receptors exist as two... 

PHENOTHIAZINES, SULPIRIDE ANTACIDS 1 levels of these antipsychotics 1 absorption Separate doses by 2 hours (in the case of sulpiride, give sulpiride 2 hours after but not before the antacid)... 

Sulpiride is eliminated by the renal route in cases of severe renal insufficiency, the dose should be decreased and intermittent treatment or switching to another antipsychotic should be considered... 

Pafienfs wifh inadequafe responses fo atypical antipsychotics may benefit from a frial of augmenfafion wifh a convenfional anfipsychofic such as sulpiride or from swifching fo a convenfional anfipsychofic such as sulpiride... 

Since the potency (therapeutic efficacy in relation to weight) of antipsychotic agents varies markedly between compounds, it is useful to think of the effective antipsychotic dose of classical agents in terms of chlorpromazine equivalents (see Table 19.5). For example, haloperidol has a relatively high anh-psychotic potency, such that 2-3 mg is equivalent to chlorpromazine 100 mg, whereas sulpiride 200 mg (low potency) is required for the same antipsychotic effect. 

Clonidine, tricyclic antidepressants md antipsychotic agents (e.g. risperidone, sulpiride) may have a role in ADHD where methylphenidate and dexamfetamine are contraindicated or have failed to produce benefit. 

The CNS stimulants methylphenidate and dexamfetamine are drugs of choice for attention deficit/hyperactivity disorder. Second line treatment options include clonidine and the antipsychotic agents risperidone, haloperidol and sulpiride. 

Antipsychotics can be divided by chemical class phenothiazines, e.g. chlorpromazine. fluphazine and thioridazine butyrophenones, e.g. haioperidol thioxanthines, e.g. nupenthixol benzamides, e.g. sulpiride diphenylbutyl-piperazines, e.g. pimozide dibenzazepines, e.g. clozapine. None is entirely selective, but in schizophrenia they act mainly at dopamine D2 receptors, though clozapine has important actions at D4 receptors. Those antipsychotics with markedly depressant side-effects are also, somewhat misleadingly, known as major tranquillizers. 

SUltopride [inn] (sultopride hydrochloride [jan] LIN 1418) is one of the substituted benzamides, with properties similar to sulpiride, and is a dopamine receptor antagonist. It has ANTIEMETIC actions, and has been used as an antipsychotic in the management of acute psychosis, sultopride hydrochloride sultopride. 

Although atypical, sulpiride had relatively low antipsychotic potency (328), possibly because of low bioavailability and poor brain penetration (329). These liabilities, coupled with the apparent atypical profile of sulpiride, spurred research in the benzamide area. 

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