Amisulpride - Uses, Interactions, Side Effects, Warnings and Precautions

Introduction:

Amisulpride is a second-generation atypical antipsychotic drug and antiemetic drug. It is used to treat mental illnesses like Schizophrenia characterized by symptoms of delusion, hallucinations, thought disorders, changes in behavior and emotions, and bipolar disorder. It is also used as an antiemetic drug to treat and prevent postoperative nausea and vomiting in adults. It is used either as a single dose or in combination with any other antiemetic drug of another drug class or group. Amisulpride is commonly sold under the brand name Solian or Sulprix.

Drug Group:

Amisulpride belongs to the group of antipsychotic drugs. The drugs in this group are used to treat mental illnesses. It is also used for treating anxiety and depression. Antipsychotic drugs are also called major tranquilizers.

Antipsychotic drugs are two types:

• Newer or atypical antipsychotics.

• Older typical well-established antipsychotics.

Newer or Atypical Antipsychotic Drugs -

These are second-generation drugs. This includes

• Amisulpride.

• Clozapine.

• Olanzapine.

• Aripiprazole.

Older Typical Well-Established Antipsychotic Drugs-

These are first-generation drugs and include:

• Chlorpromazine.

• Haloperidol.

• Levomepromazine.

• Sulpiride.

• Flupentixol.

• Pericyazine.

What Is Amisulpride Used For?

Amisulpride is used to treat mental conditions like Schizophrenia. Schizophrenia is a psychosis, a chronic and severe type of mental disorder characterized by distortions in thinking, perception, emotions, language, and behavior.

The symptoms of Schizophrenia are:

• Hallucinations.

• Delusion.

• Abnormal Behavior.

• Disorganized Speech.

• Disturbances of emotions.

How Does It Work?

Amisulpride works by altering the effect of chemicals in the brain like Dopamine, Serotonin, Noradrenaline, and Acetylcholine. These chemicals are responsible for altering your mood, emotions, and behavior. These drugs, by altering the effects of the chemicals in the brain, can prevent you from experiencing the symptoms of hallucinations, delusions, and mood swings. Amisulpride is also an antiemetic drug that prevents and alleviates postoperative nausea and vomiting. It primarily works by blocking dopamine signaling in the chemoreceptor trigger zone, which is the area in the brain that relays the stimuli to the vomiting center.

Mechanism of action:

Amisulpride can bind to D2 and D3 receptors in the limbic system. It is a highly selective antagonist of D2 and D3 dopamine receptors. Since it has a selective affinity for receptors in the limbic system and not for the receptors in the striatum, it has a low extrapyramidal symptom burden. It does not bind to other receptors called D1, D4, or D5.

Amisulpride does not have an affinity to serotonergic (5HT), adrenergic (⍺1), histaminergic (H1), or cholinergic receptors.

An animal study has found that Amisulpride is a potent 5HT-7 antagonist that can underpin antidepressant effects.

Amisulpride in low doses can block presynaptic autoreceptors. This action helps release dopamine. This resolves dopaminergic hypoactivity and symptoms of depression.

Amisulpride in high doses can block postsynaptic dopamine D2 and D3 receptors in the limbic region and prefrontal regions. This action is responsible for antipsychotic effects.

Onset of Action:

Amisulpride will not completely cure the disorder, but it will help to ease the symptoms. It takes two to four weeks for the symptoms to reduce, and may take several months for better improvement.

What Is the Dosage?

The dose of Amisulpride differs for different people depending on the health condition of the individual and the body's response to the medications. The dosage ranges from 50 milligrams per day to 800 milligrams a day. Some people may require a higher dosage of up to 1200 milligrams a day. Take the dose as prescribed by your healthcare professional. If given once daily, the dosage of Amisupride should not exceed 300 mg/day. When higher doses need to be administered, it can be given twice daily.

Note:

As Amisupride has a hypotensive and sedative effect, it should be used with caution in older adults. In the case of children, the use of Amisupride is not advised in children and teenagers below the age of 18.

How to Use Amisulpride?

Take the dose as prescribed by your healthcare professional. Depending on the prescribed dose, you can take Amisulpride once or twice a day in the morning or evening. Try to take the dose at the same time every day. It is usually recommended to take an Amisulpride dose before food. If you have difficulty swallowing the tablets, then consult your healthcare professional about changing to the liquid form.

Missed Dose:

If you missed any dose, take it as soon as you realize you missed the dose. But if it delays as such that it is the time for the next dose, then try to take the next dose at the right time. Do not take a double dose to compensate for the missed dose. Do not stop taking Amisulpride suddenly, as your symptoms may re-appear. Consult your healthcare professional before stopping the dose.

What Are the Drug Warnings or Precautions For Taking Amisulpride?

Precautions Before Taking Amisulpride:

You need to inform your healthcare professional about the medications you are taking for other illnesses. Because sometimes certain medications are not suitable for people with certain conditions or in certain situations it has to be used with caution. It has to be avoided in patients with hypokalemia, hypomagnesemia, and congestive heart failure.

Precautions While Taking Amisulpride:

• Alcohol:

Avoid taking alcohol while you are taking Amisulpride, particularly when you start taking the treatment. Drinking alcohol while taking Amisulpride can cause drowsiness, affects concentration putting you at risk of falling and other accidents. It can also cause forgetfulness, agitation, and aggression. Do not stop the medication abruptly.

• Gaining Weight:

Do monitor your weight. Inform your healthcare professional if you are putting on too much weight after taking the medication, particularly when you start the treatment.

• Blood Tests:

Taking Amisulpride may result in changes in your blood glucose level, your cholesterol level, and your heart function. Keep monitoring your blood pressure, heart rate, liver functioning, and kidneys.

Pregnancy:

There is not much information or data available regarding the use of pregnant women to establish a drug-associated risk of major congenital disabilities, miscarriage, or adverse maternal or fetal outcomes.

Lactation:

There is no information on the adverse effects of Amisulpride on milk production, and it also has no effects on breastfed children.

Precautions to be taken when Amisulpride is taken through an intravenous route:

• If severe vomiting and nausea continue after leaving the hospital, healthcare professionals must be sought for help.

• It should not be used along with Levodopa. This combination may cause ill effects.

• It may have an effect on the heart like a change in the heart rhythm, and heartbeats.

• It may make the individual faint or cause serious side effects.

• Before taking any other medications with this drug, consultation is to be done with the healthcare provider. Other medications include medicines, vitamin supplements, or herbs.

What Are the Side Effects of Amisulpride?

The common side effects are

• Weight gain.

• Feeling sleepy.

• Constipation.

• Changes in menstruation.

• Unusual production of breast milk.

• Breast enlargement in men.

• Impotence in men.

• Trouble getting an erection.

• Blurred vision.

• Changes in the movements.

• Imbalance while walking.

• Muscle stiffness.

• Trembling.

Some side effects are not very commonly seen, such as:

• Nasal congestion.

• High cholesterol.

• Increase in blood pressure.

• Slowing heart rate.

What Are the Drug Interactions of Amisulpride?

There are some medications and herbal supplements that interact with Amisulpride.

• Drugs that are contraindicated are:

  • Levodopa.

• Drugs that need to be used with caution are:

  • Beta-blockers.

  • Calcium channel blockers.

  • Hypokalemia diuretics.

  • Stimulant laxatives.

  • Amphotericin B.

  • Glucocorticoids.

  • Neuroleptics.

  • Antidepressants.

Inform your healthcare professional before taking Amisulpride about the medications you are taking for other illnesses.

What Are the Common Trade Names or Brand Names of Amisulpride?

The common brand names are:

• Tablet Solace.

• Tablet Sulprix.

• Tablet Amisure.

• Tablet Amisit.

• Tablet Ampicon.

• Tablet Aride SR-200.

• Injection Barhemsys.

Conclusion:

Amisulpride is a dopamine receptor antagonist used to treat schizophrenia. It is also known to be an antiemetic medication used to prevent postoperative nausea and vomiting. Since it has selective affinity to only D2 and D3 receptors it is preferred to be used. It has antipsychotic action that relieves both positive and negative symptoms of schizophrenia. It also reduces depression in certain conditions. Hence it becomes important to know everything about the drug called Amisulpride.