Sulpiride: An Antipsychotic Against Vertigo

Sulpiride is an antipsychotic or neuroleptic drug. It has a benzodiazepine structure and is classified as a dopamine receptor antagonist. Dopamine, in turn, is a fundamental neurotransmitter for the nervous system because it participates in a large number of physiological responses.

It is particularly important in motor functions, as it regulates the movements of the body. It also acts on emotional responses and sensations, as well as on the cognitive system and behavior.

High dopamine levels, however, are associated with mental disorders such as schizophrenia and psychosis. For this reason, many of the antipsychotic drugs are anti-dopaminergic, meaning they block the effects of this neurotransmitter.

Sulpiride has been shown to be a highly effective drug in various mental disorders. It is useful in psychosomatic syndromes, in senile dementia, in gastrointestinal somatizations, and in dizziness.

In which cases is sulpiride indicated?

Therapeutic indications of this medicine include:

• Treatment of depressive disorders with psychotic symptoms; in combination with antidepressants, provided that the latter alone have not proved effective.
• Other severe forms of depression resistant to antidepressants.
• Treatment of acute and chronic psychosis.
• Treatment of vertigo in cases where they do not respond to the usual antivertigenic drugs.

As we have said, sulpiride is an antipsychotic drug, but it is not only used in mental disorders; it is also useful in neurological diseases, such as in the case of vertigo.

We are talking about a symptom that affects about 23% of the world population and is a frequent reason for medical examination. Its prevalence generally tends to increase with age. It is an erroneous sensation of movement produced by an alteration of orientation in space. Its origin usually resides in the structures of the inner ear or anywhere else in the vestibular pathways of the central nervous system.

Mechanism of action

Sulpiride acts as a specific antagonist of dopamine D2 and D3 receptors. Its effect mainly depends on the dose taken, which must always be prescribed and monitored by the doctor.

At a low dose, it affects psychotic pictures with negative symptoms, but almost no effect on positive symptoms. At higher doses, it improves positive symptoms in patients with acute or chronic psychosis. Very high doses of sulpiride can have sedative effects.

As for its antivertigenic action, sulpiride blocks D2 receptors in the trigger zone of chemoreceptors, inhibiting vomiting.  It also acts on the mechanisms of balance regulation and on the sense of spatial orientation.

It has a powerful vestibular suppressive effect and is particularly useful in the symptomatic treatment of nausea and vomiting that can accompany dizziness and motion sickness . It is usually taken orally, but in severe cases it can also be given intramuscularly.

Side effects

The most common side effects of sulpiride treatment are:

• Insomnia.
• Sedation or sleepiness.
• Extrapyramidal disorders.
• Parkinson-like symptoms.
• Tremor.
• Hyperprolactinemia.
• Constipation.
• Increased liver enzymes.
• Chest pain.
• Weight gain.
• Galactorrhea.

It is important to inform your doctor of any adverse reactions that may occur during treatment. To avoid interactions, its administration should not be combined with antiparkinsonian or antiarrhythmic drugs. Likewise, to avoid undesirable effects, the dosage and duration of treatment indicated by the specialist must always be respected.

In the event of an overdose, there is no specific antidote. Treatment will be symptomatic, especially monitoring of cardiac function. In case of extrapyramidal symptoms, anticholinergic drugs will be administered.