Amisulpride: Uses And Side Effects Of This Antipsychotic Drug
Schizophrenia and other psychotic disorders are some of the most severe mental health problems that generate the greatest disruption and suffering. Hallucinations, delusions, catatonia, erratic and disorganized behavior, flight of ideas or altered speech are some of the symptoms that may appear, and they represent a split or partial break with reality.
But fortunately, over time and from various branches of science, different methodologies have been generated to reduce the symptoms and maintain the stability of those who suffer from it, so that they can maintain a normative life. Among them, the use of antipsychotic drugs stands out, a fundamental pillar of the treatment of this condition. And one of the many that exist is amisulpride which we are going to talk about throughout this article.
Amisulpride is an antipsychotic drug, that is, a medication or substance with psychoactive properties whose effects contribute to combating psychotic symptoms, especially with regard to problems such as hallucinations and delusions.
Is about an antipsychotic derived from included within the atypical or second generation neuroleptics which were developed with the purpose of combating the previously mentioned symptoms without the frequent side effects that the first generation ones have.
In addition, one of the main advantages of the second generation is that they achieve a therapeutic effect on negative symptoms (those that involve mental impoverishment of the patient and a loss of functionality, such as abulia and apathy, alogia or impoverishment of the language), something in which first-generation neuroleptics fail or do not have much effect (in some cases they even get worse).
This medicine is sold in the form of tablets, and its main route of administration is oral. With a half-life of 12 hours, it is partially metabolized and excreted through urine and feces. Its high potency makes it comparable to highly recognized typical antipsychotics, such as haloperidol, although it is much safer and generates less discomfort and side effects than these. It has also been compared with other drugs such as risperidone, a comparison in which amisulpride has a slight superiority in terms of effectiveness.
Mechanism of action
The mechanism of action of amisulpride is based on its effect on our brain chemistry, specifically on the dopaminergic system. Even though he is an atypical or second generation, something that usually implies that in addition to dopamine It also has an effect on the serotonergic system amisulpride is an exception: it only has a relevant effect on dopamine receptors.
Specifically, amisulpride is a dopamine D2 and D3 receptor antagonist drug With doses less than 300 mg, its effect occurs in the receptors of presynaptic neurons, something that has the effect of increasing dopamine levels by inhibiting its reuptake. This aspect is essential to treat negative symptoms, given that this is linked to a dopaminergic deficit in the mesocortical pathway.
On the other hand, if the doses are greater than or equal to 400 mg, the antagonistic effects occur on the postsynaptic neurons, which implies that dopamine will not be used by these neurons and will be degraded, with dopamine having less effect and its levels being reduced with time. This is very useful to combat positive symptoms linked to an excess of dopamine in the mesolimbic pathway.
Amisulpride, as an antipsychotic or neuroleptic, has schizophrenia as its main therapeutic indication. In this sense, amisulpride is useful both in the treatment of psychotic outbreaks and acute states as well as in more chronic phases as well as in the prevention of new outbreaks.
In addition, it must be taken into account that this drug is effective in both positive and negative symptoms, with great effectiveness in both. Although it is not an official indication, it has also sometimes been used in cases of depression and dysthymia.
Side effects
Although amisulpride is a very useful drug, its administration can cause a series of annoying or even dangerous side effects (although comparatively these effects usually occur in a smaller magnitude and less frequently than with the typical ones).
Some of the most common are the existence or appearance of tremors, hypotension, reduced libido and difficulties reaching orgasm, increased prolactin in the blood that can cause sexual disorders (menstrual problems, erectile dysfunction or galactorrhea or the emission of milk). for the breasts, among others). At the gastric level they can cause constipation, nausea and vomiting. Although to a lesser extent than other neuroleptics, it can also cause some drowsiness and slight weight gains. Other common side effects are dystonia or dyskinesia, anxiety and irritability.
Others with greater danger may be possible hyperglycemia, cardiac alterations and arrhythmias, seizures, agranulocytosis (reduction of granulocytes, a type of white blood cell), leukopenia (the number of white blood cells is reduced), hypercholesterolemia or hyponatremia. In addition, cardiac symptoms, venous thromboembolisms, angioedemas or even the potentially fatal neuroleptic malignant syndrome may occur. It can also contribute to the growth of various types of tumors.
The use of amisulpride is contraindicated for all those people who are allergic to this drug or any of its components. It should also be avoided by people who suffer or have suffered tumors such as breast, pituitary or adrenal gland. Those people who have or have had epilepsy should avoid its consumption.
Nor should people with heart or cardiovascular problems, kidney problems or failure take it (at least the dose should be reduced and controlled), Parkinson’s (the drug can impair parkinsonian symptoms) or other dementias (the risk of stroke triples and the risk of death from infectious causes increases). Diabetic patients should also take special caution, as the drug can cause hypotension or high blood pressure. In this sense, those with cardiovascular problems should also avoid it or consult its suitability to control the doses.
Its consumption should be avoided together with alcohol, lithium salts, antacids, antidepressants, antihypertensives, antiarrhythmics, antipsychotics, or levodopa, among others. Those who suffer from blood or endocrine problems should monitor and control their condition, given the risk of alterations in white blood cells and blood composition.
Pregnant and lactating women are also contraindicated in this drug given that although there is not enough data in this regard, exposure to antipsychotics during pregnancy can cause alterations in babies, or even neonatal withdrawal syndrome.
