Sulpiride: An Antipsychotic For Vertigo
Sulpiride is an antipsychotic or neuroleptic drug. It has a benzodiazepine structure and is classified within specific dopamine receptor antagonists. In turn, dopamine is a fundamental neurotransmitter in our nervous system because it regulates a large number of responses in the body.
It is especially important in motor function, since it regulates body movements. It also acts on emotional responses and sensations, as well as cognition and behavior, among others.
High dopamine levels are associated with mental illnesses, such as schizophrenia or psychoses. For this reason, many of the antipsychotic drugs are antidopaminergic and block the effects of this neurotransmitter.
Sulpiride has proven to be a highly effective drug in various psychological disorders. It is effective in psychosomatic syndromes, senile dementia, gastrointestinal somatizations, dizziness …
What is sulpiride used for?
The therapeutic indications included in the technical data 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 severe forms of depression resistant to antidepressants.
- Treatment of acute and chronic psychoses.
- Treatment of vertigo in cases in which there is no response to the usual antivertiginous treatment.
As we have seen, sulpiride is an antipsychotic drug but it is not only used in mental disorders but it is also useful in neurological diseases. In the case of vertigo, this drug has also been shown to be effective. We are talking about a symptom that affects approximately 23% of the general population and 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 at some point 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 administered dose, which should always be prescribed and controlled by the doctor.
At low doses, it has an effect on psychotic pictures with negative symptoms, but hardly any effect on positive symptoms. At higher doses, they improve positive symptoms in patients with acute or chronic psychoses. Very high doses of sulpiride can have sedative effects.
Regarding its antivertiginous action, sulpiride blocks D2 receptors in the chemoreceptor trigger area and, therefore, inhibits vomiting. It also acts on the regulatory mechanisms of balance and the sense of spatial orientation.
It has a powerful vestibular suppressive effect and is especially useful in the symptomatic treatment of nausea and vomiting that can accompany vertigo and motion sickness. It is generally administered orally, but in the most severe cases it can also be administered intramuscularly.
Side effects
The most common side effects of sulpiride treatment are:
- Insomnia.
- Sedation or drowsiness
- Extrapyramidal disorder.
- Parkinsonism symptoms.
- Shaking.
- Hyperprolactinemia
- Constipation.
- Increased liver enzymes.
- Chest pain.
- Weight gain.
- Galactorrhea.
It is important to notify the doctor of any adverse reactions that are 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 indicated by the specialist must always be respected.
In case of overdose, there is no specific antidote for sulpiride. Treatment would be symptomatic, especially controlling cardiac function. In case of extrapyramidal symptoms, anticholinergic drugs will be administered.
