Amisulpride is not currently available in the U.S. Is appears to be as good as other atypical anti-psychotics, but probably not any better.
Better than Haldol: DB 319 pt Paris for 4 weeks. Amisulpride at 100, 400, 800, 1200 vs Haldol 16mg/d. Amisulpride at 400-800 best level and very effective for positive symptoms and fewer s-e than with haldol. Acta Psych Scand ’98;98:65;
A Little Better Than Haldol: DB 191 pts acute exacerbation. Better for negative symptoms and fewer s-e. Moller, Germany, Psychopharm Berlin ’97;132:396
Better than Haldol but Some EPS: Randomized open trial 12 months 488 pts. Amisulpride considerably better on decreasing BPRS and improving quality of life. Extrapyramidal symptoms were more frequent for haloperidol (48/118, 41% versus 96/370, 26% for amisulpride), leading to a greater requirement for antiparkinsonian medication (haloperidol 66/118, 56% versus amisulpride 118/370, 32%). Haloperidol significantly aggravated parkinsonism, akathisia and involuntary movement compared to amisulpride. Long-term safety and efficacy of amisulpride in subchronic or chronic schizophrenia. Amisulpride Study Group. Colonna L, Saleem P, Dondey-Nouvel L, Rein W. France. Int Clin Psychopharmacol. 2000 Jan;15(1):13-22
As Good As or Better than Flupentixol: DB 8 week 139 pt found D2 selective antagonist amisulpride as good or better than flupenthixol which also antagonizes D1 and 5-HT2 and fewer side-effects. U Mainz, Psychopharm (Berlin)’98;137:223
Amisulpride better than Traditionals in Meta-Analysis: Eighteen randomized controlled trials of amisulpride (N=2,214) were found. In 11 studies of acutely ill patients it proved to be consistently more effective than conventional antipsychotics for global schizophrenic symptoms (measured with the Brief Psychiatric Rating Scale) and negative symptoms. Amisulpride is to date the only atypical antipsychotic for which several studies of patients suffering predominantly from negative symptoms have been published. In four such studies amisulpride was significantly more effective than placebo. Three small studies with conventional antipsychotics as comparators showed only a trend in favor of amisulpride in this regard. Univ Munich. Amisulpride, an unusual "atypical" antipsychotic: a meta-analysis of randomized controlled trials. Leucht S, Pitschel-Walz G, Engel RR, Kissling W. Am J Psychiatry. 2002 Feb;159(2):180-90
Amisulpride = Olanzapine (Zyprexa) with Less Weight Gain: 377 Canadian schizophrenics with exacerbations were treated in a DB study for 6 months with 2 month results analyzed here. Amisulpride 200-800 mg. vs. olanzapine 5-20 mg./day were used. Both showed equal on improvement in BPRS. Weight gain with olanzapine was 6# vs. 2# with amisulpride. A double-blind, randomised comparative trial of amisulpride versus olanzapine in the treatment of schizophrenia: short-term results at two months. Martin S, Ljo H, Peuskens J, Thirumalai S, Giudicelli A, Fleurot O, Rein W; SOLIANOL Study Group. Curr Med Res Opin. 2002;18(6):355-62
Amisulpride As Good as Olanzapine (Zyprexa) for Schizophrenia: In a 6-month DB PC study of amisulpride (200-800 mg/day) or olanzapine (5-20 mg/day), the improvement of BPRS score was 32.7% in the amisulpride group and 33.0% in the olanzapine group. Amenorrhoea was encountered only in the amisulpride group (6.2%), whereas elevations of liver transaminases were more frequent in the olanzapine group (17% versus 3.7%). Weight gain was higher in the olanzapine group (35.1% and 3.9 kg) than in the amisulpride group (20.6% and 1.6 kg). A double-blind, randomized comparative trial of amisulpride versus olanzapine for 6 months in the treatment of schizophrenia. Mortimer A, Martin S, Loo H, Peuskens J; SOLIANOL Sudy Group. University of Hull. Int Clin Psychopharmacol. 2004 Mar;19(2):63-9.
As Good or Better Than Risperidone: DB Schiz with worsening of symptoms. Called atypical. Less obesity and sex diff. Neuropsychopharmacology 2002 Dec;27(6):1071-81
Amisulpride Better than Risperidone in Large, Long-Term DB: 309 chronic schiz with exacerbation in multi-center DB study of amisulpride 400-1000mg/d vs. risperidone 4-10mg/d. Significantly (p <.05) superior to risperidone in terms of response (>/=50% improvement in PANSS and BPRS total scores or "very much/much improved" on the Clinical Global Impression Scale) and also demonstrated better functional effects and subjective response. Both treatments were well tolerated and had a similar low incidence of extrapyramidal symptoms; however, amisulpride was associated with less weight gain and endocrine/sexual symptoms.
France. Amisulpride vs. risperidone in chronic schizophrenia: results of a 6-month double-blind study. Sechter D, Peuskens J, Fleurot O, Rein W, Lecrubier Y; Amisulpride Study Group. Neuropsychopharmacology. 2002 Dec;27(6):1071-81
Amisulpride better than Risperidone in DB: 228 pt 8 weeks amisulpride 800mg/d vs. risperidone 8mg/d. Amisulpride vs. risperidone in the treatment of acute exacerbations of schizophrenia. Both required antiparkinsonian medication, 30 and 23% in the amisulpride and risperidone groups, respectively (P = 0.21). Patients receiving risperidone experienced an increase in body weight, which was significantly greater than for amisulpride (P = 0.026). Amisulpride study group. Peuskens J, Bech P, Moller HJ, Bale R, Fleurot O, Rein W. Belgium. Psychiatry Res. 1999 Nov 8;88(2):107-17
Amisulpride = Risperidone: 48 pt 6 weeks 400-800 vs 4-8mg/d. Similar improvement and rate of side-effects with wt gain with risperidone only. Amisulpride versus risperidone in the treatment of schizophrenic patients: a double-blind pilot study in Taiwan. Hwang TJ, Lee SM, Sun HJ, Lin HN, Tsai SJ, Lee YC, Chen YS.
Amisulpride better for Depressed Schizophrenics than Haldol or Risperidone: Review of three DB studies of 611 pts. Belgium. Amisulpride improves depressive symptoms in acute exacerbations of schizophrenia: comparison with haloperidol and risperidone. Peuskens J, Moller HJ, Puech A. Eur Neuropsychopharmacol. 2002 Aug;12(4):305-10
Amisulpride Low Dose Fine for Negative Symptoms: 242 schizophrenics with predominantly negative symptoms treated DB PC with amisulpride 50mg/d or 100mg/d. Both amisulpride groups did equally better.Strasbourg Univ. Improvement of schizophrenic patients with primary negative symptoms treated with amisulpride. Amisulpride Study Group. Danion JM, Rein W, Fleurot O. Am J Psychiatry. 1999 Apr;156(4):610-6
Sulpiride: Useful Add-On to Clozapine: DB PC 28 pt resistant to traditional and partially responsive to Cloz had Sulp 600mg/d vs placebo added with improvement in both pos and neg symptoms. Shiloh, Isreal, Br J Psych ’98;171:569
Recommended as First Line RX: New Zealand study says research shows equal to atypicals and better than haldol at 400-800mg and up to 1200OK with 50-300 for those with only negative symptoms chronically. CNS Drugs 2002;16(3):207-11
Sulpiride: Meta-Analysis: 18 DB studies 982 pts. Sulpiride non-signif better than typical antipsychotics ((RR 0.85) and less akathesia and dyskinesia (RR 0.73). Soares, Brazil, APA 5/99
Amisulpride Raises Prolactin: Amisulpride does raise prolactin more than any other atypical. Psychiatr Prax. 2003 May;30 Suppl 2:S97-101;
Amisulpride Doesn't Have 5-HT(2A) Receptor Antagonism: Treatment with amisulpride results in a similar pattern of limbic cortical over striatal D(2)/D(3) receptor blockade to that of other atypical antipsychotic drugs. This finding suggests that modest striatal D(2) receptor occupancy and preferential occupancy of limbic cortical dopamine D(2)/D(3) receptors may be sufficient to explain the therapeutic efficacy and low extrapyramidal symptom profile of atypical antipsychotic drugs, without the need for 5-HT(2A) receptor antagonism. Am J Psychiatry. 2003 Aug;160(8):1413-20 Case of Amisulpride Mania: Br J Psychiatry. 2003 Aug;183:172
|