Sulpiride, sold under the brand name Dogmatil among others, is an atypical antipsychotic (although some texts have referred to it as a typical antipsychotic) medication of the benzamide class which is used mainly in the treatment of psychosis associated with schizophrenia and major depressive disorder, and sometimes used in low dosage to treat anxiety and mild depression. Sulpiride is commonly used in Asia, Central America, Europe, South Africa and South America. Levosulpiride is its purified levo-isomer and is sold in India for similar purpose. It is not approved in the United States, Canada, or Australia. The drug is chemically and clinically similar to amisulpride. Medical uses Sulpiride's primary use in medicine is in the management of the symptoms of schizophrenia. It has been used as both a monotherapy and adjunctive therapy (in case of treatment-resistance) in schizophrenia. It has also been used in the treatment of dysthymia. There is evidence, although low quality, that Sulpiride could accelerate antidepressant response in patients with major depressive disorder. There is also evidence of its efficacy in treating panic disorder. Sulpiride is indicated for the treatment of vertigo in some countries. In Japan, Sulpiride is both approved as a treatment for schizophrenia and for major depressive disorder (low dose). Contraindications Contraindications Hypersensitivity to sulpiride Pre-existing breast cancer or other prolactin-dependent tumors Phaeochromocytoma Intoxication with other centrally-active drugs Concomitant use of levodopa Acute porphyria Comatose state or CNS depression Bone-marrow suppression Cautions Pre-existing Parkinson's disease Patients under 18 years of age (insufficient clinical data) Pre-existing severe heart disease/bradycardia, or hypokalemia (predisposing to long QT syndrome and severe arrhythmias) Patients with pre-existing epilepsy. Anticonvulsant therapy should be maintained Lithium use — increased risk of neurological side effects of both drugs Pregnancy and lactation Pregnancy: Animal studies did not reveal any embryotoxicity or fetotoxicity, nor did limited human experience. Due to insufficient human data, pregnant women should be treated with sulpiride only if strictly indicated. Additionally, the newborns of treated women should be monitored, because isolated cases of extrapyramidal side effects have been reported. Lactation: Sulpiride is found in the milk of lactating women. Since the consequences are unclear, women should not breastfeed during treatment. Side effects Sulpiride is usually well tolerated, producing few adverse effects. Their incidences are as follows: Common (>1%) adverse effects Dizziness Headache Extrapyramidal side effects - Tremor - Dystonia - Akathisia — a sense of inner restlessness that presents itself with the