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Sullivan is an antipsychotic drug with the main active ingredient Amisulpride. Sullivan is indicated in the treatment of acute and chronic schizophrenia with positive or negative symptoms. The following article provides you with information on indications and precautions when taking Sullivan.
1. What is Sullivan?
Sullivan drug has the main active ingredient is Amisulpride, is made in the form of capsules with the strength of 100mg and 400mg.
Amisulpride has a high affinity for dopamine D2 and D3 receptors, it has no affinity for D1, D4, and D5. Amisulpride also has no affinity for serotonin, alpha adrenergic, cholinergic, histamine H1 receptors, nor does Amisulpride bind to the sigma site.
Amisulpride has the effect of blocking D2/D3 receptors, presynaptic, causing dopamine release, effective for symptoms of schizophrenia.
2. Indications and contraindications of the drug Sullivan
Indications for Sullivan:
Sullivan is indicated in the treatment of acute and chronic schizophrenia with positive symptoms, such as hallucinations, delusions, thought disturbances or symptoms. negative as wanting to withdraw from social life. Sullivan is contraindicated for use in the following cases:
Hypersensitivity reaction to Amisulpride or any ingredient of Sullivan's drug. Prolactin-dependent tumors such as pituitary adenomas, breast cancer. Pheochromocytoma. Children under 15 years old (before puberty). Pregnant. Breastfeeding women. Do not combine with the following drugs because they can cause torsades de pointes: Quinidin, Disopyramid, Amiodarone, Procainamide, Sotalol, Cisaprid, Bepridil, Sultorid, Thioridazine, Intravenous Vincarnin, Intravenous Erythromycin, Halofantrin, Sparfloxacin, Pentamidine, Levodopa .
3. How to take the drug Sullivan
How to use:
Sullivan is used orally. Swallow the tablet whole with water, do not chew or crush the tablet. Take Sullivan pills before meals. If you feel that the effect of Sullivan's medicine is too strong or too weak, do not change the dose on your own and consult your doctor. Dosage:
When using a dose of 300mg/day or less, take 1 time/day. If the dose is over 300mg/day, then divided into 2 times/day. Acute phase: 400-800mg/day. Dosage may be adjusted according to individual patient response. In some cases the dose can be increased up to 1200mg/day. Maintain the lowest clinically effective dose of Sullivan. In the case of patients with both positive and negative symptoms, adjust the dose for optimal control of the positive symptom. For patients with predominantly negative symptoms, the dose is in the range of 50-300 mg/day. Elderly: Use with caution due to risk of hypotension and sedation. Children: Sullivan is not recommended for children under 18 years of age. The use of Sullivan is contraindicated in children before puberty because there are no data on the safety and efficacy of the drug in this age group. Patients with renal impairment: Creatinine clearance about 30 - 60mL/min orally 1/2 dose; Creatinine clearance is about 10-30mL/min orally 1/3 of the dose. Patients with hepatic impairment: Amisulpride is metabolized by the liver sparingly, so it is not necessary to adjust the dose of Sullivan in this patient. Overdose and management:
Symptoms of overdosage of Sullivan: hypotension, somnolence, coma and extrapyramidal symptoms. Fatal cases of Sullivan overdose have often been reported with concomitant use of other antipsychotics. In the case of acute drug overdose, the possibility of multiple drug use should be considered. Management: Hemodialysis is not effective for Amisulpride overdose and there is no specific antidote. Patient monitoring, symptomatic and supportive treatment are key. In the case of patients with severe extrapyramidal symptoms, use anticholinergic drugs. Because of the risk of QT prolongation, ECG monitoring is required until the patient recovers.
4. Note when using the drug Sullivan
Neuroleptic malignant syndrome (high fever, autonomic dysfunction, muscle stiffness, increased CPK) may occur with the use of Sullivan. In the event of a high fever, especially at high doses, all psychotropic drugs should be discontinued. Hyperglycemia: Has been reported in patients treated with Amisulpride. Therefore, patients with diabetes or at risk of diabetes should closely monitor their blood sugar before starting treatment with Amisulpride. Renal Impairment: Amisulpride is eliminated by the kidneys; dose adjustment is required in patients with renal impairment. Epilepsy patients: Amisulpride lowers the seizure threshold, and Sullivan should be used with caution in patients with a history of epilepsy. Elderly Patients: Caution should be exercised in elderly patients due to the risk of hypotension and sedation. It may be necessary to reduce the dose of Sullivan due to impaired renal function of the patient. Parkinson's: Only use Sullivan for Parkinson's patients when absolutely necessary, because it can make the condition worse. Acute withdrawal symptoms such as nausea, vomiting and insomnia have been reported following abrupt discontinuation of high doses of sedatives. Recurrence of psychotic symptoms and occurrence of involuntary movement disorders have also been reported. Therefore, when wanting to stop taking Sullivan, it is necessary to reduce the dose gradually and avoid abrupt discontinuation. Amisulpride may prolong the QT interval on the electrocardiogram, increasing the risk of severe ventricular arrhythmias such as torsades de pointes if the patient has pre-existing bradycardia (less than 55 beats/min), hypokalemia, or congenital prolongation of the QT interval. . In randomized versus placebo-controlled clinical studies in the elderly population with dementia and treated with atypical antipsychotics, the risk of cerebrovascular events was 3-fold increased. The mechanism for this is unknown. Therefore, the possibility of cerebrovascular events that may occur with the use of Sullivan cannot be excluded. Use with caution in patients at risk of cerebrovascular accident. Older people with dementia: Clinical studies have shown that elderly people with memory loss when treated with antipsychotics have a higher risk of death. Thromboembolism: A few cases of thromboembolism have been reported in patients receiving antipsychotics. In addition, patients treated with antipsychotics often have risk factors for thromboembolism, therefore it is necessary to determine the risk factors for thromboembolism before, during, and after amisulpride use. Breast cancer: Amisulpride increases prolactin levels, which should be used with caution in patients with a history or family history of breast cancer. Hemocytopenia: Leukopenia, granulocytopenia, and neutropenia have been reported with antipsychotics, including Amisulpride. Unexplained infections or fever may be evidence that Sullivan is affecting the blood, requiring immediate blood tests. Sullivan 400mg contains lactose, should not be used in patients with impaired glucose tolerance, Lapp-lactase deficiency or glucose-galactose metabolism disorders. Ability to drive and use machines: Amisulpride can cause drowsiness, somnolence, affect the ability to drive and use machines. Care should be taken when using the drug Sullivan. Pregnancy: Clinical data on the safety of amisulpride in pregnant women are limited. The use of Sullivan during pregnancy is not recommended unless the benefits outweigh the risks. Women of childbearing age should talk to their doctor about effective birth control before using Sullivan. Neonates exposed to antipsychotic drugs (including Amisulpride) during the third trimester of pregnancy are at increased risk of adverse events including withdrawal symptoms of varying severity and duration. outside the tower. Symptoms such as agitation, spasticity, tremor, hypotonia, respiratory distress, lethargy, or eating disorders have been reported in children. Children should be carefully monitored in the event of exposure to Amisulpride. Lactation: It is not known whether Amisulpride is excreted in human milk and therefore the use of Sullivan is contraindicated in nursing women.
5. Undesirable effects when using the drug Sullivan
When using Sullivan in treatment, you may experience some unwanted effects.
Nervous system: Very common: Extrapyramidal symptoms may occur such as tremor, spasticity, dyskinesia, increased salivation. These symptoms are usually mild with optimal dosing and are partially reversible without discontinuation of Amisulpride. The frequency of extrapyramidal symptoms is dose dependent with amisulpride, with a low frequency in predominantly symptom-negative patients receiving doses of 50-300 mg/day. Acute neuromotor disturbances (convulsive torticollis, ophthalmoplegia, jaw stiffness) may appear, lethargy. Uncommon: Tardive dyskinesia characterized by rhythmic involuntary movements mainly of the face or tongue – usually after prolonged use, convulsions. Neuroleptic malignant syndrome occurs with unknown frequency and is potentially fatal. Psychiatric: Insomnia, anxiety, restlessness, orgasmic disorder. Gastrointestinal: Constipation, vomiting, nausea, dry mouth. Skin: rash, urticaria. Cardiovascular: Low blood pressure, bradycardia. QT interval prolongation and ventricular arrhythmias such as arrhythmia, the fastest rhythm, leading to ventricular fibrillation and cardiac arrest, sudden death. Thromboembolism, including pulmonary embolism, deep vein thrombosis. Endocrine: Amisulpride causes a reversible increase in prolactin levels after discontinuation of the drug, causing amenorrhea, increased lactation, gynecomastia, breast tenderness, and erectile dysfunction. Hematology: Leukopenia, neutrophils, granulocytes. Metabolism: Hyperglycemia, hypertriglyceridemia, hypercholesterolemia. Neonatal smoking cessation syndrome.
6. Drug interactions
Contraindications to the combination of Sullivan with the following drugs:
Antiarrhythmic drugs of class Ia: Disopyramid, Quinidine, Procainamide. Class III antiarrhythmic drugs: Sotalol, Amiodarone. Bepridil, Thioridazine, Sultoprid, Cisaprid, Intravenous Erythromycin, Intravenous Vincamine, Pentamidine, Halofantrin, Sparfloxacin. Levodopa. Sullivan should not be combined with alcohol because of the increased effect of alcohol on the central nervous system.
Care should be taken when combining Sullivan with drugs that increase the risk of torsades de pointes:
Drugs that slow the heart rate such as beta-blockers, calcium channel blockers such as Verapamil, Diltiazem, Clonidine, Digitalis, Guanfacin. Drugs causing hypokalemia: diuretics that lower blood potassium, stimulant laxatives, Glucocorticoids, Tetracosazides, Amphotericin B intravenously. Neuroleptics such as Haloperidol, Pimozide, Lithium, Imipramine. Consider when combining Sullivan with:
Central nervous system depressants such as anesthetics, tranquilizers, analgesics, H1 antihistamines causing drowsiness, Benzodiazepines, Barbiturates. Antihypertensive drugs. Dopamine agonists: because of reducing the effect of Amisulpride. Above is all information about the drug Sullivan, patients need to carefully read the instructions for use, consult a doctor / pharmacist before using. Note, Sullivan is a prescription drug, patients need to use it according to the doctor's prescription, absolutely do not self-treat at home.
