Amisulpride

Oral
Acute psychosis

CrCl (mL/min)	Dosage
10-30	One-third of the usual dose.
31-60	Half the usual dose.

Should be taken on an empty stomach. Preferably taken before meals.

Phaeochromocytoma, concomitant prolactin-dependent tumours (e.g. pituitary gland prolactinomas or breast cancer). Pre-pubertal childn. Combination w/ levodopa.

Patient w/ history of epilepsy; Parkinson's disease, CV disease. Avoid abrupt withdrawal. Renal impairment. Elderly. Pregnancy and lactation.

Insomnia, anxiety, agitation, drowsiness, wt gain, acute dystonia, parkinsonism, akathisia, tardive dyskinesia, QT prolongation, hypotension, bradycardia, GI disorders (e.g. constipation, nausea, vomiting, dry mouth), hyperglycaemia; breast pain, erectile dysfunction, amenorrhoea, gynaecomastia, galactorrhoea. Rarely, allergic reactions, abnormal LFTs, seizures.
Potentially Fatal: Neuroleptic malignant syndrome.

This drug may cause somnolence, if affected, may impair ability to drive or operate machinery.

Symptoms: Generalised convulsions, coma, motor restlessness, tachycardia, slight prolongation of the QT interval, drowsiness, sedation, hypotension, extrapyramidal symptoms. Management: Symptomatic and supportive treatment. Institute close supervision of vital functions including continuous cardiac monitoring until patient recovers. Perform gastric lavage. In case severe extrapyramidal symptoms occur, administer anticholinergic agents.

Increased risk of arrhythmias w/ cisapride, thioridazine, halofantrine, erythromycin, some antiarrhythmics, pimozide, haloperidol, TCAs, β-blockers, some Ca channel blockers, clonidine, guanfacine, digoxin, K-depleting diuretics, lithium, antimalarials. May enhance effects of antihypertensives and CNS depressants (e.g. sedative H₁-antihistamines, narcotics, anaesthetics, analgesics, barbiturates, benzodiazepines, other anxiolytics, clonidine and derivatives).
Potentially Fatal: Reciprocal antagonism between levodopa and neuroleptics.

May enhance central effects of alcohol.

Description:
Mechanism of Action: Amisulpride is a substituted benzamide atypical antipsychotic which binds selectively w/ a high affinity to human dopaminergic D₂ and D₃ receptor subtypes.
Pharmacokinetics:
Absorption: Absorbed from GI tract. Bioavailability: Approx 48%. Time to peak plasma concentration: 1 hr (initial); 3-4 hr (2nd).
Distribution: Volume of distribution: 5.8 L/kg. Plasma protein binding: Approx 16%.
Metabolism: Limited metabolism.
Excretion: Mainly via urine as unchanged drug. Terminal elimination half-life: Approx 12 hr.

Source: National Center for Biotechnology Information. PubChem Database. Amisulpride, CID=2159, https://pubchem.ncbi.nlm.nih.gov/compound/Amisulpride (accessed on Jan. 20, 2020)

Store below 25°C.

Antipsychotics

Buckingham R (ed). Amisulpride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 17/11/2014.

Joint Formulary Committee. Amisulpride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 17/11/2014.