Tiapride: characteristics and side effects of this drug.

An antipsychotic drug used in some diseases whose effects extend beyond the brain.

Antipsychotics are generally classified into typical (or first generation) and atypical (or second generation). In this article we will discuss tiapride, an atypical antipsychotic that selectively blocks which selectively blocks dopamine D₂ and D₃ receptors in the brain. Let's see what its characteristics are.

Tiapride: characteristics.

Tiapride is an atypical or second-generation antipsychotic.. It is an antidopaminergic (decreases the concentration of dopamine in the brain), belonging to the benzamide group.

On the other hand, this drug has antipsychotic, low potency and antiemetic (prevents vomiting) action.

In addition, stimulates prolactin production, has mild sedative and alpha-adrenergic blocking action.. On the other hand, its anticholinergic action is almost null.

Mechanism of action

Tiapride is an atypical neuroleptic that selectively blocks dopamine selectively blocks dopaminergic D2 and D3 receptors; as a consequenceAs a consequence, the concentration of dopamine in the brain decreases.

Indications

We know that antipsychotics are generally used to treat the positive symptoms (and to a lesser extent, the negative symptoms) of different types of psychosis. However, some antipsychotics are also used to treat other clinical pictures or diseases, as we will see.

Tiapride is indicated for severe behavioral disorders in children in a state of agitation and aggression, which do not respond to other 1st line treatment. It is also indicated in severe Huntington's chorea, in patients who do not respond to 1st line treatment.It is also indicated in patients who do not respond to 1st line treatment, as well as in cases of dysphemia and Tourette's Syndrome.

Contraindications

Thiapride is contraindicated in cases of hypersensitivity to it, in prolactin-dependent tumors (e.g. pituitary prolactinoma and breast cancer), in pheochromocytoma, in association with levodopa (metabolic precursor of dopamine, indicated to treat Parkinson's disease) or in combination with dopaminergic drugs.

On the other hand, there are a number of combinations that are not recommended when taking tiapride. These are:

• Alcohol.
• Levodopa (medication for the treatment of Parkinson's disease).
• Dopaminergic agonists other than levodopa (amantadine, apomorphine, bromocriptine, entacapone, lisuride, pergolide, piribedil, pramipexole, ropinirole, selegiline) in patients with Parkinson's disease.
• Methadone (pain-relieving medication).
• Medications that can induce Heart rhythm disturbances (torsades de pointes).

Warnings and precautions

Caution should be exercised (and the dosage reduced) in patients with a history of epilepsy, the elderly, children, and patients with risk factors for epilepsy.and patients with risk factors for cerebral embolism.

On the other hand, tiapride is associated with a risk of producing serious ventricular arrhythmias.. Thiapride should not be used in Parkinson's disease, and treatment should be discontinued in case of hyperthermia (increase in body temperature above normal) of unknown origin due to risk of neuroleptic malignant syndrome (NMS).

Pregnancy and lactation

Regarding the use of tiapride in pregnancy, animal studies have been performed, and no harmful effects have been found.

However, there is little clinical data in pregnant women, so tiapride should be used with caution.. If used in late pregnancy, it may induce tachycardia, hyperexcitability, abdominal distension, meconium retardation and sedation in the neonate.

Regarding lactation, animal studies have demonstrated excretion of tiapride in breast milk; since no data are available concerning the excretion of tiapride in breast milk in humans, breast-feeding is not recommended during treatment with tiapride (or if lactating, the use of tiapride is not recommended).

Side effects.

Adverse reactions described from tiapride are: dizziness or lightheadedness, headache, tremor, increased muscle tone, slowing of movementIn children, there are no specific data for tiapride, increased salivation, somnolence, insomnia, agitation, indifference, hyperprolactinemia, asthenia/fatigue, involuntary movements.

In children there are no specific data for adverse reactions.

Bibliographic references:

• Stahl, S.M. (2002). Essential psychopharmacology. Neuroscientific bases and clinical applications. Barcelona: Ariel.
• Therapeutic Prescription Guide AGEMED. (2006). Fichas Técnicas (available in CIMA at http://www.aemps.es). Medimecum® (drug therapy guide, 17th ed.).
• Villa, L.F. editor. (2011). Medimecum, guide to drug therapy. 16th ed. Spain: Adis.