Impatiens

Levosulpiride, sold under the brand name SULPEPTA , is a potent prokinetic agent of the benzamide class.^[1] It is a selective antagonist of the dopamine D₂ receptors and 5HT4 Agonism ^[2] on both central and peripheral nervous systems. Levosulpiride is claimed to have mood elevating properties.

Chemically, it is the (S)-(−)-enantiomer of sulpiride.

Uses

Levosulpiride is used in the treatment of:

• Psychosis
• Negative symptoms of schizophrenia
• Anxiety disorders
• Dysthymia
• Vertigo
• Dyspepsia
• Irritable bowel syndrome
• Premature ejaculation.

Levosulpiride is not currently licensed for treatment of premature ejaculation in the UK or other European countries.^[3]

Side effects

Side effects include amenorrhea, gynecomastia, galactorrhea, changes in libido, and neuroleptic malignant syndrome.^[4] In the U.S., as of 2013 only one case of adverse reaction to levosulpiride had been recorded on the FDA Adverse Event Reporting System Database.^[3] A case of rapid onset resistant dystonia caused by low dose levosulpiride was reported in India.^[5]

Mechanism of action

In contrast to most other neuroleptics which block both D₁ and D₂ receptors, levosulpiride is more selective and acts primarily as a D₂ antagonist. Levosulpiride appears to lack effects on norepinephrine, acetylcholine, serotonin, histamine, and gamma-aminobutyric acid (GABA) receptors.^[6]

Pharmacodynamics

Levosulpiride is a substituted benzamide derivative and a selective dopamine D₂ antagonist with antipsychotic and antidepressant activity. Other benzamide derivatives include metoclopramide, tiapride, and sultopride.^[6]

See also

• Sulpiride
• Veralipride
• Benzamide

References