Side Effects
Sulpiride has fewer extrapyramidal side effects (dystonia, parkinsonism, and akathisia) than many of the older antipsychotic medications.
Sulpiride can occasionally increase motor agitation and can cause or worsen aggressive, agitated or excitation symptomatology; therefore caution is required in individuals who have mania or hypomania as these side effects are more likely in this population of people. Other adverse effects include delirium/confusion, catatonia, depression, somnolence, lassitude and insomnia and other sleep disturbances, overstimulation and agitation may occur. Also possible is the development of extrapyramidal effects, such as akathisia, acute dystonia and parkinsonism; tardive dyskinesia develops rarely. Patients with no history of convulsions have experienced convulsions as a result of sulpiride therapy. Sulpiride can cause withdrawal symptoms if the drug is withdrawn too quickly. Some of these withdrawal symptoms include nausea, vomiting, sweating and insomnia; psychotic symptoms may also reoccur, as well as involuntary movement disorders, including akathisia, dystonia and dyskinesia. Gradual reduction when discontinuing therapy is therefore advised by experts to reduce the incidence and severity of any possible withdrawal symptoms.
Most of these do not seem to occur in a dose related manner. Other side effects occur infrequently (hypotension, rarely long-QT syndrome, dry mouth, sweating, nausea, activation or sedation, insomnia, allergic rash or pruritus). Isolated cases of the potentially life-threatening NMS (neuroleptic malignant syndrome) have been reported. Sulpiride should not be taken after 4 p.m. in order to avoid insomnia. The foremost problem with sulpiride is a strong stimulation of prolactin-secretion; whether this may contribute to the development of breast-cancer in women is currently not known.
- Levodopa : Sulpiride and levodopa have antagonistic effects.
- Alcohol : Sedation and hypotension may be potentiated.
- Antihypertensive agents : Hypotension may be potentiated (risk of postural collapse).
- Other central depressants : Increased sedation with negative impact on the capacity to drive or operate machinery.
Read more about this topic: Sulpiride
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