Tiapride: characteristics and side effects of this drug

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

• Related article: "Types of antipsychotics (or neuroleptics)"

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 group of benzamides.

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

Besides, stimulates the production of prolactin, has a slight sedative and alpha-adrenergic blocking action. On the other hand, its anticholinergic action is almost nil.

Mechanism of action

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

• You may be interested in: "Dopamine: 7 essential functions of this neurotransmitter"

Indications

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

Tiapride is indicated for severe behavioral disorders in children in a state of agitation and aggression, who 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, as well as in cases of dysphemia and Tourette Syndrome.

contraindications

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

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

• Alcohol.
• Levodopa (a drug for the treatment of Parkinson's).
• Dopamine agonists other than levodopa (amantadine, apomorphine, bromocriptine, entacapone, lisuride, pergolide, piribedil, pramipexole, ropinirole, selegiline) in patients with Parkinson.
• Methadone (medicine that relieves pain).
• Medications that can induce heart rhythm disturbances (torsades de pointes).

Warnings and Cautions

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

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

Pregnancy and lactation

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

However, there are few clinical data in pregnant women, therefore tiapride should be used with caution. If used in the last phase of pregnancy, it can induce tachycardia, hyperexcitability, abdominal distension, meconium retardation and sedation in the newborn.

Regarding lactation, animal studies have shown excretion of tiapride in breast milk; Since no data are available regarding the excretion of tiapride in human breast milk, the use is not recommended. breast-feeding during treatment with tiapride (or if breast-feeding, use of the tiapride).

Side effects

The adverse reactions described from tiapride are: dizziness or vertigo, headache, tremor, increased muscle tone, slowing of movement, increased salivation, drowsiness, 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.
• AGEMED Therapeutic Prescription Guide. (2006). Technical Sheets (available at TOP of the page http://www.aemps.es). Medimecum® (pharmacological therapy guide, 17th ed).
• Villa, L.F. editor. (2011). Medimecum, drug therapy guide. 16 edition. Spain: Goodbye.