Schizophrenia amisulpride

Peuskens J, Bech P, Moller HJ, Bale R, Fleurot O, Rein W. Amisulpride vs. risperidone in the treatment of acute exacerbations of schizophrenia. Amisulpride Study Group. Psychiatry Res 1999 88(2) 107-17. 

In a 6-month randomized, controlled trial in 304 patients with schizophrenia amisulpride was compared with risperidone (12). The percentage of patients that responded to treatment was significantly greater with amisulpride 200-800 mg than risperidone 2-8 mg amisulpride was superior to risperidone with respect to weight gain, as only 18% of amisulpride-treated patients increased their weight by more than 7% after 6 months compared with 33% of risperidone-treated patients. 

Several clinical trials with adults have demonstrated that amisulpride is effective in improving positive and negative symptoms of schizophrenia (Moller, 2000). There is one clinical trial including adolescent and young adulthood schizophrenia (Paillere-Martinot, 1995). Amisulpride was generally well tolerated and improved both positive and negative symptoms. 

Fixed doses of amisulpride (100, 400, 800, and 1200 mg/ day) and haloperidol (16 mg/day) have been compared in a 4-week, double-blind, randomized trial in 319 patients with acute exacerbations of schizophrenia (33). Amisulpride 400 mg/day and 800 mg/day was effective in treating the positive symptoms of schizophrenia, with fewer extrapyramidal adverse effects than haloperidol,... 

The results of 11 studies in 1933 patients with schizophrenia, who were randomly assigned to amisulpride (n = 1247), haloperidol (n = 309), risperidone (n = 113), flupenthixol (n = 62), or placebo (n = 202) have been reviewed (45). Extrapyramidal signs occurred in 15% of those given amisulpride (n = 579), 12% of those given risperidone (n = 113), and 31% of those given haloperidol (n = 214). In contrast, endocrine disorders were more frequent with amisulpride (4%) and risperidone (6%) than with haloperidol (1%). In a subgroup of patients with predominant negative schizophrenia who had at... 

Mota NE, Lima MS, Soares BG. Amisulpride for schizophrenia. Cochrane Database Syst Rev 2002 (2) CD001357 http //www.cochrane.org/cochrane/revabstr/ AB001357.htm. 

Puech A, Fleurot O, Rein W. Amisulpride, and atypical antipsychotic, in the treatment of acute episodes of schizophrenia a dose-ranging study vs. haloperidol. The Amisulpride Study Group. Acta Psychiatr Scand 1998 98(l) 65-72. 

Colonna L, Saleem P, Dondey-Nouvel L, Rein W. Longterm safety and efficacy of amisulpride in subchronic or chronic schizophrenia. The Amisulpride Study Group. Int Clin Psychopharmacol 2000 15(l) 13-22. 

Amisulpride 600-1200 mg/day for 3 months was effective and well tolerated in 445 patients with schizophrenia aged 18 15 years (1). During this time, 124 patients (28%) dropped out of the study 21% reported adverse events, neurological (35%), psychiatric (15%), or endocrine (9.1%). Seven adverse events were assessed as serious two suicides, two suicide attempts, one neuroleptic malignant syndrome, one somnolence, and one worsening of arteritis. 

In a randomized comparison of amisulpride with olanzapine in 377 patients with schizophrenia with predominantly positive symptoms, who were treated for 6 months with either amisulpride 200-800 mg or olanzapine 5-20 mg, positive and negative scores were similar for amisulpride and olanzapine new weight gain was less in amisulpride-treated patients by day 56, amisulpride recipients had gained 0.4 kg whereas olanzapine recipients had gained 2.7 kg (Mortimer S21). 

There were moderate but significant improvements in neurocognition (including executive function, working memory, and declarative memory) in a randomized, double -blind, 8-week study in 52 patients with schizophrenia assigned either to olanzapine (10-20 mg/day n = 18) or amisulpride (400-800 mg/day n = 18) (11). Of 16 dropouts, six were due to adverse events olanzapine—sedation (n = 2) and increased transaminases (n = 1) amisulpride—rash, extrapyramidal symptoms, and galactorrhea (n — 1 each). 

Lecrubier Y, Azorin M, Bottai T, Dalery J, Garreau G, Lemperiere T, Lisoprawski A, Petitjean F, Vanelle JM. Consensus on the practical use of amisulpride, an atypical antipsychotic, in the treatment of schizophrenia. Neuropsychobiology 2001 44(l) 41-6. 

Agelink MW, Kavuk I, Ak I. Clozapine with amisulpride for refractory schizophrenia. Am J Psychiatry 2004 161 924-5. 

Amisulpride is used for both acute and chronic schizophrenia treatment... 

Burns T, Bale R. Clinical advantages of amisulpride in the treatment of acufe schizophrenia. J Inf Med Res 200f 29 (6) 451-66. 

II Lower doses of amisulpride (e.g. 100 mg/day) are indicated for patients with negative symptoms of schizophrenia only. 

In a study in 24 healthy subjects, lithium carbonate 500 mg twice daily was given for 7 days to obtain stable lithium serum levels, and then amisulpride 100 mg twice daily or placebo was added for a further 7 days. Amisulpride appeared to have no effect on lithium pharmacokinetics. In a pharmacokinetic analysis of amisulpride levels in patients with schizophrenia or schizoaffective disorder, dose-corrected amisulpride plasma levels were 1.8-fold higher in 3 patients taking lithium than in 13 patients taking amisulpride alone. Further study is needed to confirm this finding and establish its clinical significance. 

Systematic reviews Amisulpride and other atypical antipsychotic drugs (olanzapine, risperidone, and ziprasidone) have been compared in people with schizophrenia and schizophrenia-like psychoses in an analysis of 10 short- to medium-term trials with 1549 participants [56 ]. The overall attrition rate was considerable (35%), with no significant difference between the groups. Amisulpride was as effective as olanzapine and risperidone and more effective than ziprasidone. Amisulpride caused less weight gain than risperidone and olanzapine. Olanzapine was associated with a greater rise in blood glucose. There were no differences in cardiac and extrapyrami-dal reactions. 

Systematic reviews First-generation and second-generation antipsychotic drugs in patients with schizophrenia have been compared in a meta-analysis [14= ] (for an in-depth review, see SEDA-27, 50). The study included 150 double-blind, mostly shortterm, randomized clinical trials with 21 533 participants. Four second-generation antipsychotic drugs (amisulpride, clozapine, olanzapine, and risperidone) were better than first-generation ones for overall... 

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