inability to stay still - Parkinsonism Somnolence (not a very prominent adverse effect considering its lack of α1 adrenergic, histamine and muscarinic acetylcholine receptor affinity) Insomnia Weight gain or loss Hyperprolactinemia (elevated plasma levels of the hormone, prolactin which can, in turn lead to sexual dysfunction, galactorrhea, amenorrhea, gynecomastia, etc.) Nausea Vomiting Nasal congestion Anticholinergic adverse effects such as: - Dry mouth - Constipation - Blurred vision Impaired concentration Rare (<1% incidence) adverse effects Tardive dyskinesia — a rare, often permanent movement disorder that, more often than not, results from prolonged treatment with antidopaminergic agents such as antipsychotics. It presents with slow (hence tardive), involuntary, repetitive and purposeless movements that most often affect the facial muscles. Neuroleptic malignant syndrome — a rare, life-threatening complication that results from the use of antidopaminergic agents. Its incidence increases with concomitant use of lithium (medication) salts Blood dyscrasias — rare, sometimes life-threatening complications of the use of a number of different antipsychotics (most notably clozapine) which involves abnormalities in the composition of a person's blood (e.g. having too few white blood cells per unit volume of blood). Examples include: - Agranulocytosis — a significant drop in white blood cell count, leaving individuals wide open to life-threatening opportunistic infections - Neutropenia - Leucopenia - Leukocytosis Seizures Torsades de pointes Unknown incidence adverse effects include QTc interval prolongation which can lead to potentially fatal arrhythmias. Cholestatic jaundice Elevated liver enzymes Primary biliary cirrhosis Allergic reactions Photosensitivity — sensitivity to light Skin rashes Depression Catatonia Palpitations Agitation Diaphoresis — sweating without a precipitating factor (e.g. increased ambient temperature) Hypotension — low blood pressure Hypertension — high blood pressure Venous thromboembolism (probably rare) Overdose Sulpiride has a relatively low order of acute toxicity. Substantial amounts may cause severe but reversible dystonic crises with torticollis, protrusion of the tongue, and/or trismus. In some cases all the classical symptoms typical of severe Parkinson's disease may be noted; in others, over-sedation/coma may occur. The treatment is largely symptomatic. Some or all extrapyramidal reactions may respond to the application of anticholinergic drugs such as biperiden or benzatropine. All patients should be closely monitored for signs of long QT syndrome and severe arrhythmias. Interactions Sulpiride neither inhibits nor stimulates cytochrome P450 family (CYP) of oxidizing enzymes in human, thus would not cause clinically significant interactions with other drugs, which are metabolized by CYPs. However, the risk or severity of adverse effects can be