Levosulpiride: a review of its clinical use in psychiatry

Influence of ABCB1 genetic polymorphisms on the pharmacokinetics of levosulpiride in healthy subjects

Background: Injectable antipsychotics are frequently required for controlling agitation and aggression in acute psychosis. No study has examined the use of injectable levosulpiride for this indication.
Objective: To compare the efficacy and safety of injectable levosulpiride and haloperidol in patients with acute psychosis.
Methods: This was a randomized, double-blind, parallel-group study in which 60 drug-naive patients having acute psychosis were randomly assigned to receive either intramuscular haloperidol (10–20 mg/d) or levosulpiride (25–50 mg/d) for 5 days. All patientswere rated on Brief Psychiatric Rating Scale (BPRS), Overt Agitation Severity Scale (OASS), Overt Aggression Scale–Modified (OAS-M) scores, Simpson Angus Scale (SAS), and Barnes Akathisia Rating Scale (BARS).
Results: Repeated-measures ANOVA for BPRS scores showed significant effect of time (P < 0.001) and a trend toward greater reduction in scores in haloperidol group as shown by group � time interaction (P = 0.076). Repeated-measures ANOVA for OASS showed significant effect of time (P < 0.001) but no group � time interaction. Repeatedmeasures ANOVA for OAS-M scores showed significant effect of time (P < 0.001) and greater reduction in scores in haloperidol group as shown by group � time interaction (P = 0.032). Lorazepam requirement was much lower in haloperidol group as compared with those receiving levosulpiride (P = 0.022). Higher rates of akathisia and extrapyramidal symptoms were noted in the haloperidol group.
Conclusions: Haloperidol was more effective than levosulpiride injection for psychotic symptoms, aggression, and severity of agitation in acute psychosis, but extrapyramidal adverse effects were less frequent with levosulpiride as compared with those receiving haloperidol.

Efficacy and safety of levosulpiride versus haloperidol injection in patients with acute psychosis: A randomized double-blind study

The primary objective of this study was to compare the therapeutic effect of low-dose levosulpiride with pimozide in a representative sample of patients with negative symptoms of schizophrenia As a secondary objective, possible synergism between haloperidol and levosulpiride was evaluated The safety of the two drugs in association with haloperidol was also compared This was a single-masked (the patient), randomized, controlled, clinical study performed on 20 hospitalized patients randomly assigned to one of two groups The drugs under study were administered orally, during a 60-day period, at the following doses: levosulpiride 200 mg/d or pimozide 4 mg/d All patients had chronic schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised, with pre-dominant negative symptoms, following Andreasen's diagnostic criteria, based on rating scales for negative and positive symptoms of schizophrenia Low-dose levosulpiride showed a definite therapeutic effect on negative symptoms of schizophrenia The therapeutic activity of levosulpiride was higher than that of pimozide A particular type of synergism between levosulpiride and haloperidol was also suggested, as negative symptoms of schizophrenia, which are not relieved by haloperidol alone, were significantly ameliorated by adding levosulpiride to the therapeutic schedule The combination of levosulpiride plus haloperidol did not increase the incidence of side effects; in fact, the incidence of side effects with combination therapy was decreased in comparison with that of haloperidol monotherapy The total number of side effects was similar during combination therapy with pimozide plus haloperidol and during haloperidol monotherapy

Levosulpiride versus pimozide in negative symptoms of schizophrenia

Die Gruppe der orthomethoxy-substituierten Benzamide setzt sich aus einer inzwischen grosen Zahl zum Teil pharmakologisch-neurobiochemisch sehr heterogenen Substanzen zusammen. Zu den therapeutisch verfugbaren substituierten Benzamiden gehoren die Substanzen Sulpirid, Remoxiprid, Amisulprid und Moclobemid (Abb. 1). Studien zur Behandlung schizophrener Minussymptomatik finden sich vor allem mit Sulpirid, Remoxiprid und Amisulprid.

Therapeutische Moglichkeiten der Benzamide bei Minussymptomatik

Efficacy of low vs. high doses of levosulpiride on negative symptoms of schizophrenia.

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Efficacy of low vs. high doses of levosulpiride on negative symptoms of schizophrenia.