Sulpiride: an antipsychotic for vertigo

Sulpiride is an antipsychotic or neuroleptic drug. It has a benzodiazepine structure and is classified as a specific dopamine receptor antagonist. At the same time, Dopamine is a fundamental neurotransmitter in our nervous system because it regulates a large number of the body’s responses.

It is especially important in motor function, since regulates body movements. It also acts on emotional responses and sensations, as well as cognition and behavior, among others.

High levels of dopamine are associated with mental illnesses, such as schizophrenia or psychoses. For this reason, many antipsychotic drugs are antidopaminergic and block the effects of this neurotransmitter.

Sulpiride has proven to be a highly effective drug in different psychological disorders.. It is effective in psychosomatic syndromes, senile dementia, gastrointestinal somatizations, vertigo…

What is sulpiride used for?

The therapeutic indications included in the technical sheet of this medicine are the following:

Treatment of depressive disorders with psychotic symptoms in combination with antidepressants, provided that antidepressants alone have proven ineffective.Other resistant severe forms of depression to antidepressants.Treatment of acute and chronic psychoses.Vertigo treatment in cases in which there is no response to the usual antivertigin treatment.

As we have seen, sulpiride is an antipsychotic drug, but it is not only used in mental disorders, but also It is also useful in neurological diseases. In the case of vertigo, this drug has also proven to be effective. We talk about a symptom that affects approximately 23% of the general population and it is a frequent reason for consultation in primary care consultations. Generally, its prevalence tends to increase with age.

It is a hallucinatory sensation of movement produced by an alteration of orientation in space. Its origin is usually in the structures of the inner ear or somewhere in the vestibular pathway of the central nervous system.

Mechanism of action

Sulpiride acts as a specific antagonist of dopamine D2 and D3 receptors.. Its effect depends mainly on the dose administered, which should always be prescribed and controlled by the doctor.

At low doses, it has an effect on psychotic symptoms with negative symptoms, but with little effect on the positive symptoms. At higher doses, positive symptoms improve in patients with acute or chronic psychoses. Very high doses of sulpiride may have sedative effects.

Regarding its antivertiginous action, sulpiride blocks D2 receptors in the chemoreceptor trigger area and, therefore, inhibits vomiting. Also It acts on the regulatory mechanisms of balance and the sense of spatial orientation.

It exerts a powerful vestibular suppressive effect and is especially useful in the symptomatic treatment of nausea and vomiting that can accompany vertigo and motion sickness. Generally administered orallybut in more severe cases it can also be administered intramuscularly.

Side effects

The most common side effects in treatment with sulpiride are:

Insomnia.Sedation or drowsiness.Extrapyramidal disorder. Symptoms of parkinsonism.Shaking.Hyperprolactinemia.Constipation.Increase in liver enzymes.Chest pain.Weight gain.Galactorrhea.

It is important to notify your doctor of any adverse reactions experienced during treatment. To avoid interactions, Its administration should not be combined with antiparkinsonian or antiarrhythmic drugs.. Likewise, to avoid unwanted effects, The dosage and duration of treatment must always be respected indicated by the specialist.

In case of overdose, there is no specific antidote for sulpiride.. Treatment would be symptomatic, especially controlling cardiac function. If extrapyramidal symptoms exist, anticholinergic drugs will be administered.

Contraindications

The main contraindications of sulpiride are those related to hypersensitivity and pregnancy. The first refers to the possibility of triggering an allergic reaction in a hypersensitive patient, while the second refers to the fact that the medication crosses the placenta and breast milk, affecting the fetus.

Additionally, sulpiride is contraindicated in other conditions:

Prolactin-dependent tumors, such as breast cancer. Pheochromocytoma. Cardiovascular disorders involving prolongation of the QT interval. Renal failure. Seizures. History of stroke. History of thromboembolism.

Interaction of sulpiride with other medications

One of the major pharmacological interactions of sulpiride is with levodopa, since both medications act on the same receptors in the brain. Levodopa is a dopamine precursor that is commonly used for the treatment of Parkinson’s.

Another substance that interacts with sulpiride is grapefruit juice. This is an enzyme inducer, that is, it stimulates liver enzymes and increases the metabolism of the drug. In this way, the medication will have a shorter presence in the blood.

It should also not be consumed together with alcohol, as it enhances the sedative effect of the medication.. In addition, certain compounds can increase the risk of suffering arrhythmias, extrapyramidal syndrome and hypotension, among which the following stand out:

Beta blockers.Calcium channel antagonists.Diuretics.Some antiarrhythmics.Lithium salts.Imipraminic antidepressants.

Antacids with magnesium or aluminum salts decrease the bioavailability of the drug. Thus, sulpiride should be consumed at least 2 hours before them to avoid interactions.

In short, this drug has various useful applications for humans and many of them have been scientifically proven. However, remember that any type of pharmacological treatment must be prescribed by the corresponding professional.

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