Abstract
Amisulpride is an antipsychotic available in Europe since 1990s, in Poland since 2000. Subsequent years brought to Polish market more second-generation compounds such as ziprasidone and aripiprazole. In 2018, the Agency for Health Technology Assessment and Tariff System issued positive recommendation for lurasidone in schizophrenia (Recommendation 30/2018) facilitating its entry to the market. Thanks to new molecules, therapeutic possibilities of medicines consequently rise, however, higher number of available substances of different properties brings also more dilemmas which one to pick. Since new publications of comparative drug trials, meta-analyses and systematic reviews are issued regularly, the authors present herein publications issued within last ten years focusing on amisulpride as opposed to other neuroleptics used in Poland. Although in many aspects it is equivalent to other atypical antipsychotics, it still has some advantages. Amisulpride seems to have better outcome than classic and atypical neuroleptics when it comes to depressive symptoms and predominant negative symptoms. It might also be superior to haloperidol in inducing symptomatic remission in first episode schizophrenia. Except for prolactin increase its side effects profile is favorable - it rarely leads to extrapyramidal symptoms (which are dose-dependent) and sedation. Therefore many patients accept treatment with amisulpride for its measurable clinical gains, such as improvement of positive symptoms and higher quality of life, compared to typical neuroleptics. Pharmacokinetics of amisulpride also encourage its wider use, especially when there is either a need for combined psychopharmacotherapy or comorbidity with general medical condition rises a need for somatic parallel treatment.
Highlights
Since 1952, the year when chlorpromazine was first introduced to the market, the era of psychopharmacotherapy is in its ascendance
Today, leaning on our personal clinical experiences and even more on evidence-based medicine (EBM), we can chose from many medicines prescribing these to our patients in an individualized manner supporting them in overcoming psychotic crisis
The only legal indication in Poland for amisulpride is: “treatment of acute and chronic schizophrenic disorders in which positive symptoms and negative symptoms are prominent, including patients characterized by predominant negative symptoms” [16]
Summary
Since 1952, the year when chlorpromazine was first introduced to the market, the era of psychopharmacotherapy is in its ascendance. It transformed contemporary psychiatry of social exclusion of the insane into modern psychiatry of their reintegration with the society. It is the very virtue of the subsequent more and more efficient and selective antipsychotics. The ultimate goal is the resumption of once lost social roles leading to improved quality of life of the patient and their close relatives bearing the burden of mental illness in the family [1]
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