Sulprix 100mg (amisulpride)

Sulprix general information

What is Sulprix used for?

Sulprix tablets 100mg are used to treat acute and chronic schizophrenia, a condition which is described as a group of brain disorders that causes disruption of normal brain functions resulting in abnormal interpretation of reality, due to a disruption of normal thought processes and emotions.  Schizophrenia is thought to be a neurological disorder, due to a difference in brain structure and function, with an hereditary component.  Symptoms of schizophrenia are general classified into three categories.  Positive symptoms include delusions, hallucinations, thought disorders and disorganised behaviour.  Negative symptoms include social and emotional withdrawal, inability to carry out planned activities, loss of interest in everyday activities and neglect of personal hygiene.  Cognitive symptoms include problems understanding information, difficulty paying attention and memory problems.  Sulprix tablets 100mg help reduce both positive and negative symptoms of schizophrenia.

How does Sulprix work?

Sulprix tablets 100mg contain amisulpride, which is an atypical neuroleptic antipsychotic drug of the benzamide class, used in the treatment of schizophrenia.  Amisulpride in Sulprix tablets 100mg acts as a dopamine antagonist and binds selectively to the dopamine D2 and D3 receptors but has low affinity for other neurotransmitter receptors including serotonin, adrenergic, histamine and muscarinic receptors.  Dopamine is a neurotransmitter (brain chemical that allows brain cells to communicate) and it is thought that an imbalance in dopamine in the brain, due to over activity of dopamine, contributes to symptoms of schizophrenia.  This dopamine over activity may be a result of excess pre- synapse dopamine release (gap between nerve cells across which chemical messages are sent from one nerve cell to another) or (due to excessive stimulation of the post-synapse (receiving nerve cell) dopamine D2 receptors or an increase in numbers of D2 receptors¹.  Amisulpride in Sulprix tablets 100mg blocks dopaminergic transmission in the brain by blocking D2 receptors both pre- synapse and post-synapse but preferentially blocking post-synaptic receptors in the limbic region of the brain, which is the area of the brain involved in regulating emotion and memory.  Amisulpride in Sulprix tablets 100mg helps control symptoms of schizophrenia and is effective for both positive and negative symptoms.

What does Sulprix contain?

Sulprix tablets 100mg contain the active ingredient amisulpride, an antipsychotic medication used to treat schizophrenia.  They also contain lactose monohydrate, cellulose microcrystalline, sodium starch glycolate, hypromellose and magnesium stearate.

Treating schizophrenia with Sulprix

Sulprix tablets 100mg contain amisulpride, an antipsychotic medication used to treat schizophrenia, by blocking dopamine receptors in the brain.  Schizophrenia is a brain disorder that causes disruption of normal brain functions resulting in abnormal interpretation of reality due to a disruption of normal thought processes and emotions.  Symptoms of schizophrenia are general classified into three categories.  Positive symptoms include delusions, hallucinations, thought disorders and disorganised behaviour.  Negative symptoms include social and emotional withdrawal, inability to carry out planned activities, loss of interest in everyday activities and neglect of personal hygiene.  Cognitive symptoms include problems understanding information, difficulty paying attention and memory problems.  Dopamine is a neurotransmitter (brain chemical that allows brain cells to communicate) and it is thought that an imbalance in dopamine in the brain, due to over activity of dopamine, contributes to symptoms of schizophrenia.  This over activity may be due to excessive release of dopamine, excessive stimulation of dopamine D2 receptors or an increase in numbers of D2 receptors.  Amisulpride in Sulprix tablets 100mg helps control symptoms of schizophrenia and is effective for both positive and negative symptoms.

What are the side effects of Sulprix?

The most commonly reported side effects when taking Sulprix tablets 100mg include extrapyramidal symptoms such as: tremor, rigidity, hypokinesia (reduced body movement), hypersalivation (excessive production of saliva), akathisia (a feeling of inner restlessness), dyskinesia (uncontrolled involuntary movement), acute dystonia (repeated involuntary muscle contractions); Insomnia, anxiety, agitation; gastrointestinal upset including constipation, nausea, vomiting, dry mouth; hypotension (low blood pressure); weight gain; increased blood prolactin causing galactorrhoea (milk secretion from the breasts), amenorrhoea, gynaecomastia (breast enlargement in men), breast pain, and erectile dysfunction.

When should Sulprix not be used?

You should not use Sulprix tablets 100mg if you:

• are allergic to amisulpride or any ingredients in Sulprix
• are pregnant or are breastfeeding
• have a prolactin-dependent tumour such as prolactinoma of the pituitary gland and breast cancer
• have phaeochromocytoma, a tumour of the adrenal gland
• have kidney or liver disease
• have a history of blood clots, seizures, diabetes (blood sugar may need monitoring)
• have Parkinson’s disease
• are taking medicines that interact with Sulprix, including: antiarrhythmics like quinidine and amiodarone, levodopa for Parkinson’s disease, bepridil for angina cisapride for gastric reflux, other antipsychotics like sultopride and thioridazine, methadone for addiction, intravenous antibiotics like erythromycin and vincamine, the antimalarial halofantrine, pentamidine for pneumonia, the antibiotic sparfloxacin, calcium channel blockers diltiazem and verapamil, beta-blockers, clonidine, guanfacine for high blood pressure, digitalis for heart failure, narcotics, anaesthetics, analgesics, sedative antihistamines, barbiturates, benzodiazepines and other anxiolytic medicines, clonidine and derivatives, diuretics, stimulant laxatives, intravenous, glucocorticoids, the antifungal amphotericin B, glucocorticoids, other antipsychotics like haloperidol, chlorpromazine, trifluperazine, pimozide, imipramine antidepressants, lithium, alcohol, antihypertensive medicines and other hypotensive medications

What medications interact with Sulprix?

Several medications interact with Sulprix tablets 100mg and should either not be taken while you are taking Sulprix or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Sulprix: drugs that induce the heart condition torsades de pointes, including antiarrhythmics like quinidine and amiodarone, levodopa for Parkinson’s disease, bepridil for angina cisapride for gastric reflux, other antipsychotics like sultopride and thioridazine, methadone for addiction, intravenous antibiotics like erythromycin and vincamine, the antimalarial halofantrine, pentamidine for pneumonia, the antibiotic sparfloxacin; drugs that induce bradycardia, such as the calcium channel blockers diltiazem and verapamil, beta-blockers, clonidine, guanfacine for high blood pressure, digitalis for heart failure, drugs that decrease potassium levels like diuretics, intravenous antifungal amphotericin B, glucocorticoids, other antipsychotics like haloperidol, chlorpromazine, trifluperazine, pimozide, imipramine antidepressants, lithium
• Drugs that are affected by Sulprix: levodopa for Parkinson’s disease, CNS depressants including narcotics, anaesthetics, analgesics, sedative antihistamines, barbiturates, benzodiazepines and other anxiolytic medicines, clonidine and derivatives, antihypertensive medicines and other hypotensive medications, alcohol

How should Sulprix be taken?

You should take your Sulprix tablets 100mg swallowed whole with a glass of water before meals and at the same time each day. The dose you take depends on your condition and your doctor’s recommendation.  You should continue to take your Sulprix tablets 100mg for as long as recommended by your doctor, which may be for a long period even if you are feeling well, as this will continue to control your symptoms. 

How long should you take Sulprix?

You should continue to take your Sulprix tablets 100mg for as long as recommended by your doctor, which may be for a long period even if you are feeling well, as this will continue to control your symptoms. 

Missed dose of Sulprix

If you miss a dose of Sulprix take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Sulprix be stored?

You should store your Sulprix below 25°C in a cool dry place. 

References

1. Seeman P, Kapur P. Schizophrenia: More dopamine, more D2 receptors.  Proc Nat Acad Sci 97; 2000; 7673-5.