The first study, published in 2012, included 39 adults with schizophrenia who were randomized to 800 mg/d of CBD or amisulpride
(AMS), a second-generation antipsychotic that is popular in Europe but is not available in the United States.
Among atypical antipsychotics risperidone and amisulpride
affect prolactin levels more frequently while clozapine, olanzapine, quetiapine are prolactin-sparing2,3.
Among the OCD patients, 19 patients were taking only an antidepressant (mean daily dose of fluoxetine 37.3 mg, fluoxamine 244.4 mg, sertraline 147.3 mg, paroxetine 43.3 mg, citalopram 40 mg, clomipramine 157.5 mg, venlafaxine 150 mg, duloxetine 60 mg, or mirtazapine 15 mg), and 46 patients were taking an antidepressant together with an antipsychotic (mean daily dose of aripiprazole 11.04 mg, quetiapine 191.9 mg, olanzapine 5 mg, risperidone 1.75 mg, haloperidol 2.5 mg, amisulpride
175 mg, or pimozide 1 mg).
All patients had been using dopamine receptor antagonist medications (quetiapine, olanzapine, clozapine, zuclopenthixol or amisulpride
) before the onset of akathisia; three patients were also using selective serotonin reuptake inhibitors (SSRIs); and one patient was on valproic acid treatment.
4, 2018 (HealthDay News) -- Remission can be achieved for most cases of schizophrenia and schizophreniform disorder with amisulpride
and clozapine, according to a study published online Aug.
Li and colleagues found that there was improvement in the left superior temporal gyrus function and enhancement of the functional connectivity from the left STG to the dorsalateral prefrontal cortex(DLPFC) in patients with first-episode schizophrenia(FES) after taking atypical antipsychotic drugs (olanzapine, clozapine, aripiprazole, risperidone, quetiapine, or amisulpride
) for a year and these changes were correlated with the improvement of negative symptoms.
Additionally, all patients had to be on treatment with atypical antipsychotics (clozapine, olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, amisulpride
, asenapine and paliperidone), for at least three months.
However, symptoms did not improve; hence, olanzapine was cross-tapered and amisulpride
was titrated up to a dose of 1200 mg/day.
First generation antipsychotics with an increased risk of QTc prolonging include tioridazina (the highest risk), pimozide, droperidole, mesoridazine and haloperidole with intravenous administration (total cumulative dose > 2 mg) and from the second generation sertindole, amisulpride
Although both first- and second-generation antipsychotics can cause hyperprolactinemia, the risk differs between medications, with a higher risk reported in treatments involving amisulpride
, sulpiride, and risperidone .
Among antipsychotics, hyperprolactinemia is most commonly induced by sulpiride, amisulpride
, risperidone, and paliperidone.
The majority of antipsychotic medications in clinic, such as Haloperidol, Chlorpromazine, Risperidone, Amisulpride
, Sulpiride, and Olanzapine, will bring hyperprolactinemia .