Amisulpride

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[edit] BRAND NAMES

[edit] STRUCTURE

Amisulpride.jpg

[edit] MECHANISM OF ACTION

Amisulpride, is an antipsychotic drug belonging to the class of atypical antipsychotics (Second generation antipsychotics). Other atypical antipsychotic drugs include Risperidone, Paliperidone, Quetiapine, Aripiprazole, Clozapine, Ziprasidone and Olanzapine.

At higher doses (400-1200 mg/day) Amisulpride inhibits dopaminergic neurotransmission by blocking post-synaptic D2 receptors located in the limbic areas as compared to those in the striatum. its preferential limbic activity explains its reduced tendency to produce extrapyramidal side effects

At lower doses (50-200 mg) Amisulpride preferentially blocks pre-synaptic D2/D3 dopamine autoreceptors, producing dopamine release responsible for its disinhibitory effects (Active against negative symptoms)

Amisulpride may also have 5-HT7 antagonistic effect, useful in depression treatment

Unlike typical (fisrt generation) and atypical antipsychotics (Second generation), amisulpride displays low affinity for serotonin, α-adrenergic, histamine receptor subtypes, muscarinic receptors and sigma sites.

[edit] INDICATIONS

  • Treatment of acute and chronic schizophrenia, in which positive symptoms (such as delusions, hallucinations, thought disorders) and/or negative symptoms (such as blunted affect, emotional and social withdrawal) are prominent, including patients characterised by predominant negative symptoms.
  • Treatment of dysthymia (A mood disorder characterized by chronic mild depression)

[edit] DOSAGE

  • Schizophrenia: 400mg once daily or 800 mg (400mg twice daily) before meals . Maximum dose is 1200 mg/day. For patients characterised by predominant negative symptoms, oral doses between 50 mg/day and 300 mg/day are recommended.
  • Treatment of dysthymia: 50 mg/day

[edit] CONTRAINDICATIONS

[edit] WARNINGS AND PRECAUTIONS

[edit] INTERACTIONS

[edit] PREGNANCY AND LACTATION

  • Pregnancy: The safety of amisulpride during human pregnancy has not been established, and therefore use of this medicine is not recommended during pregnancy unless the benefits justify the potential risks and the administered dose and duration of treatment should be as low and as short as possible.
  • Use in Lactation: It is not known whether amisulpride or its metabolites are excreted in animal or human breast milk. Breast-feeding is therefore contraindicated during amisulpride treatment.

[edit] SIDE EFFECTS

Possible adverse reactions include:

  • Elevated serum prolactin causing amenorrhoea and galactorrhoea, breast pain and gynecomastia (Common)
  • Extrapyramidal symptoms, including tremor, rigidity, hypokinesia, hypersalivation, akathisia and tardive dyskinesia (Uncommon)
  • Orgasmic dysfunction and erectile dysfunction (Common)
  • Hyperglycemia (Uncommon)
  • Neuroleptic malignant syndrome (Rare)
  • Insomnia (Common)
  • Anxiety and agitation (Common)
  • Orthostatic hypotension

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES