Preparation "Sulpiride": reviews, indications, analogues

Psychoses of varying degrees of gravity accompanied humanity always. Over the centuries, it was believed that the devil was a devil in the sick person, and therefore the "cure" of this problem was appropriate. Before the creation of neuroleptic medicines, the coping of mental disorders was carried out with herbal preparations developed on the basis of belladonna, bleached, and opiates. It was also practiced with calcium therapy (intravenous administration) and immersion of the patient in narcotic sleep.

The first antipsychotic is aminazine, which has been actively used to treat patients with mental disabilities since 1953. At present, the list of antipsychotic medications, antipsychotics, has significantly expanded. One of the widely used drugs of this group is Sulpiride. Patients' responses characterize it as a highly effective atypical antipsychotic drug.

Pharmacodynamics of the preparation

The neuroleptic influence of "Sulpiride" is associated with antidophaminergic action, ie, in the central nervous system, the drug blocks mainly dopaminergic receptors. Dopamine is an important component of the "reward system" of the brain - it stimulates the sensations of pleasure, satisfaction, which, in turn, affects the learning and motivational processes. In sufficiently large doses, it is developed in the course of any positive experience (according to the subjective opinion of a person) - the reception of tasty 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 symptomatology of depression develops.

The action of "Sulpiride" in a dosage exceeding 600 mg (daily volume of the drug) is antipsychotic. If the dosage used is less than 600 mg, the stimulating and antidepressant effects prevail. However, the drug has little effect on serotonergic, histamine, adrenergic receptors.

Medicaments - analogues

Sulpirid, an atypical antipsychotic, belonging to the group of substituted benzamides, has a fairly large number of medicines similar in composition and effect. There are drugs that match the ATC code of the 4th level. Such are "Betamax", "Tiaprid", "Eglonil". In addition to these, "Prosulfin", "Eglek", "Restful", "Vero-Sulpirid", "Sulpirid Belupo" use wide consumer demand. Comments on all these medicines on the part of consumers can have both a positive orientation and a negative one. It all depends on the severity of the patient's health condition, its sensitivity to the main active ingredient, sulpiride, and the dosage of the medication prescribed to be taken by the attending physician.

Indications for taking medication

The neuroleptic "Sulpirid" itself, its analogs have a fairly wide sphere of influence and can be prescribed for admission for serious enough diseases. Accept it in the presence of schizophrenia in both acute stages and in its chronic course. It is justified the use of sulpiride-containing neuroleptics in the development of the acute stage of delirium (a mental disorder accompanied by a disturbance of consciousness, from the darkened consciousness to coma). Quite often the drug is prescribed for various neurotic disorders and depression, regardless of their origin.

At dizziness of the most various origin recommends to accept "Sulpirid" the instruction on application. The reviews of patients and health workers characterize the medication well in the treatment of vestibular neuritis, with vertebrobasilar insufficiency, with otitis media and craniocerebral trauma, with Meniere's disease (an increase in the volume of fluid in the cavity of the inner ear, which exerts pressure on the cells responsible for maintaining equilibrium Body and its orientation in space).

As an element of complex therapy, "Sulpiride" can be used for treatment of ulcers and irritable bowel syndrome.

Who should refrain from taking antipsychotics based on sulpiride?

Neuroleptic remedy "Sulpirid", analogues of the medicament 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 (significantly increased the level of the hormone prolactin in the blood). Accordingly, this medication is not prescribed for prolactin-dependent neoplasms (breast cancer, prolactinoma of the pituitary gland , etc.).

Further, "Sulpirid" (indications described above) the instruction prohibits taking with pheochromocytomas (hormonally active tumors of chromaffin cells), manic psychoses and various affective disorders, with behavioral aggression, epilepsy. Contraindicated in the use of sulpiride-containing medicines against the background of acute alcohol intoxication, when poisoning with hypnotic medicines and narcotic analgesics.

The use of the neuroleptic "Sulpiride" is not indicated for patients under the age of 18 years and for women during lactation.

Possible side effects

Side effects on the neuroleptic itself and analogues of "Sulpirid" reviews patients and medical workers as serious enough, significantly worsening the condition of patients. There is a possibility of developing hyperprolactinaemia in a variety of forms (gynecomastia, dysmenorrhea, frigidity, decreased potency, galactorrhea, weight gain).

Further, an extrapyramidal syndrome is possible, which is manifested by pathological disorders of the quantity and quality of spontaneous movements produced by skeletal muscles, changes in muscle tone. However, paralysis is not a symptom that confirms the development of extrapyramidal syndrome.

As side reactions to Sulpirid, analogues of neuroleptic, tremor, akathisia (impossibility to be at rest), dyskinesia, insomnia and drowsiness, anxiety, high excitability, irritability may appear. Symptoms of a malignant neuroleptic syndrome, characterized by vegetative abnormalities, pallor of the skin, hyperthermia may appear.

Side manifestations of the gastrointestinal tract may consist in sensations of dryness in the oral cavity, the development of heartburn, the appearance of nausea, vomiting, constipation. Activation of hepatic transaminases and alkaline phosphatase is possible.

Cardiovascular system for the use of "Sulpiride" can respond with an increase in blood pressure (rarely - lowering blood pressure, dizziness), increased heart rate, increased QT-interval. It is very rare, but you can hear that the reviews of doctors refer to the development of arrhythmia of the type torsadedepointes concerning the Sulpiride drug.

Possible allergic manifestations in the form of skin rashes, itching, eczematous rashes. Sometimes you can hear about a violation of visual acuity.

Dosage regimen and scheme of application

According to the instructions for the use of medication, usually adults are prescribed a dose of 100-300 mg per day depending on the disease (divided into 2-3 doses). The oral solution is prescribed in a different dosage: 100-800 mg per day for intramuscular administration (always shake before use). The maximum permissible dose for an adult is 1.6 g.

If there is a need for the appointment of "Sulpiride" to children under 18 years of age, the dosage should be calculated taking into account the mass based on 5 mg per kilogram of weight.

If a patient has a psychotic condition in acute or chronic stages, therapy is usually started with 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, from intramuscular injection, they switch to the reception of "Sulpiride" inward in the form of tablets. Neuroleptic "Sulpirid" patients' reviews are described as an effective medication. The length of the course of therapy can be determined and changed only by the attending physician.

Exceeding the permissible dose

There are no specific symptoms indicating the fact of exceeding the dose above the maximum allowable. Usually in such situations, there is an increase in blood pressure, deterioration of vision. Perhaps the development of sedative effect (suppression of consciousness, provoked by medications, sedative effect, and with further increase in the dose - hypnotics). In most cases, as a consequence of the use of the drug "Sulpiride", patients' reviews indicate the appearance of nausea, dry mouth, increased sweating, and vomiting. In rare cases, extrapyramidal symptoms develop; in male patients, gynecomastia may develop (enlargement of the breast). Very rarely they speak of pronounced parkinsonism, coma.

Since the selective antidote for "Sulpiride" is absent, it is recommended to apply symptomatic treatment depending on the patient's condition. In some cases, holinoblockers of central action are used.

What to pay special attention to?

Absolutely all preparations of the neuroleptic group (including sulpiride content "Betamax", "Vero-Sulpiride", "Prosulpin", "Sulperid Belupo", "Eglonil", "Sulpirid") are not allowed to be reviewed by experts and instructions from the alcohol-based drinks. For patients with epilepsy, clinical and electrophysiological studies are recommended, as sulpiride reduces the threshold of 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 QT-interval is dose dependent.

If the symptoms of hyperthermia appeared on the background of the treatment with "Sulpiridom" (a fact indicating the development of a malignant neuroleptic syndrome), the drug should be discarded.

A sudden discontinuation of the course of therapy with "Sulpiridom" can provoke a withdrawal syndrome. The presence of maltitol in the formulation makes it impossible to use it for people suffering from intolerance to fructose.

Throughout the entire treatment period, care must be taken to manage motor vehicles and perform work that requires a rapid reaction of psychomotor and high concentration of attention.

Sulpiride-containing medications and pregnancy

Women who took during the pregnancy "Sulpirid", reviews leave the most positive direction. The maximum allowable dose for pregnant women of 200 mg per day did not provoke a teratogenic effect (abnormalities of embryonic development). Relatively large doses of medication for expectant mothers are not available. Also, there is no evidence of the potential effect of neuroleptic drugs on the development of the baby's brain.

In general, health workers prefer not to use "Sulpiride" for the treatment of pregnant women, except when a positive effect for a woman prevails over the potential risk to the fetus. In such cases, the "Sulpirid" instruction (reviews of health workers confirm) recommends prescribing in the lowest possible dosages and, if possible, minimizing the treatment period.

In children born to women taking sulpiride-containing medications during pregnancy, occasionally there is gastrointestinal symptoms (bloating, etc.), associated with the atropine-like effect of neuroleptics. Sometimes you can hear about extrapyramidal syndrome. During breastfeeding, the "Sulpiride" is contraindicated.

Opinion of patients about "Sulpiride"

The bulk of patients about the drug "Sulpirid" reviews leaves a positive focus. Neuroleptic is quite effective and justifies the declared characteristics. People who took "Sulpirid" or its analogues about mental symptoms during peptic ulcer of the stomach or duodenal ulcer, 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 patients with frequent dizziness caused by complaints for a variety of reasons. The bulk of these patients remained satisfied with the results of the treatment.

Large doses of "Sulpiride" (more than 600 mg per day), according to medical experts, had an effective antipsychotic effect on patients. Doses of less than 600 mg, according to both doctors and patients, had a stimulating and antidepressant effect.

There is a group of patients who reacted negatively to Sulpirid. Individuals developed nausea, overexcitation, dizziness. Negative symptoms disappeared after the discontinuation of "Sulpiride".