В качестве монотерапии или в сочетании с другими психотропными препаратами:- острая и хроническая шизофрения; - острые делириозные состояния; - депрессии различной этиологии; - неврозы и беспокойство у взрослых пациентов, при неэффективности обычных методов лечения (только для капсул 50 мг); - тяжелые нарушения поведения (ажитация, членовредительство, ...
Действующее вещество: Сульпирид (Sulpiridum)Концентрация действующего вещества (мг): 200
Фармакологические свойства
Антипсихотическое средство (нейролептик) из группы замещенных бензамидов. оказывает умеренное антипсихотическое, а также антидепрессивное действие в сочетании с активирующим действием. механизм антипсихотического действия связан с избирательной блокадой центральных допаминовых d2-рецепторов. седативное действие выражено слабо, альфа-адреноблокирующая активность невысокая, практически не вызывает антимускариновых эффектов. редко вызывает экстрапирамидные расстройства, поэтому относится к атипичным нейролептикам. способствует заживлению язвенных поражений желудка и двенадцатиперстной кишки.
Показания к применению
В качестве монотерапии или в сочетании с другими психотропными препаратами:- острая и хроническая шизофрения; - острые делириозные состояния; - депрессии различной этиологии; - неврозы и беспокойство у взрослых пациентов, при неэффективности обычных методов лечения (только для капсул 50 мг); - тяжелые нарушения поведения (ажитация, членовредительство, стереотипия) у детей в возрасте старше 6 лет, в особенности в сочетании с синдромами аутизма (только для капсул 50 мг).
Противопоказания
Пролактин-зависимые опухоли (например, пролактиномы гипофиза и рак молочной железы); - гиперпролактинемия; - острая интоксикация этанолом, снотворными средствами, опиоидными анальгетиками; - аффективные расстройства, агрессивное поведение, маниакальный психоз; - феохромоцитома; - период грудного вскармливания; - детский возраст до 18 лет (для таблеток и раствора для в/м введения); - детский возраст до 6 лет (для капсул); - в комбинации с сультопридом, агонистами допаминергических рецепторов (амантадин, апоморфин, бромокриптин, каберголин, энтакапон, лизурид, перголид, пирибедил, прамипексол, кинаголид, ропинирол); - повышенная чувствительность к сульпириду или другому ингредиенту препарата. В связи с наличием в составе препарата лактозы, он противопоказан при врожденной галактоземии, синдроме мальабсорбции глюкозы/галактозы или дефиците лактазы.
Применение при беременности и в период грудного вскармливания
При беременности и в период лактации применять с осторожностью и в минимальных эффективных дозах.
Способ применения и дозы
Таблетки и капсулы принимают 1-3 раза/сут, запивая небольшим количеством жидкости, независимо от приема пищи. Цель терапии - достигнуть минимально эффективной дозы. Не рекомендуется принимать препарат во второй половине дня (после 16 ч) в связи с повышением уровня активности. ТаблеткиОстрая и хроническая шизофрения, острый делириозный психоз, депрессия: суточная доза составляет от 200 до 1000 мг, разделенная на несколько приемов.
Побочное действие
Нежелательные явления, развивающиеся в результате приема сульпирида, подобны нежелательным явлениям, вызываемыми другими психотропными средствами, но частота их развития, в основном, меньше. Со стороны эндокринной системы: возможно развитие обратимой гиперпролактинемии, наиболее частыми проявлениями которой являются галакторея, аменорея, нарушение менструального цикла, реже - гинекомастия, импотенция и фригидность. Во время лечения сульпиридом может отмечаться повышенная потливость, увеличение массы тела. Со стороны пищеварительной системы: повышение активности ферментов печени. Со стороны ЦНС: седативный эффект, сонливость, головокружение, тремор, ранняя дискинезия (спастическая кривошея, окулогирные кризы, тризм), проходящая при назначении антихолинергического противопаркинсонного средства, редко - экстрапирамидный синдром и связанные с этим нарушения (акинезия, иногда сочетающаяся с мышечным гипертонусом и частично устраняемая при назначении антихолинергических антипаркинсонных средств, гиперкинезия-гипертонус, моторное возбуждение, акатазия). Были отмечены случаи поздней дискинезии, характеризующейся непроизвольными ритмическими движениями, в основном языка и/или лица при длительных курсах лечения, что может наблюдаться в ходе курсов лечения всеми нейролептиками: применение антипаркинсонных препаратов является неэффективным или может вызвать ухудшение симптомов. При развитии гипертермии препарат следует отменить, т.к. повышение температуры тела может указывать на развитие злокачественного нейролептического синдрома (ЗНС). Со стороны сердечно-сосудистой системы: тахикардия, возможно повышение или снижение артериального давления, в редких случаях возможно развитие ортостатической гипотензии, удлинение интервала QT, очень редкие случаи развития синдрома torsade depointes. Аллергические реакции: возможна кожная сыпь.
Особые указания
С осторожностью применяют у пациентов с паркинсонизмом, лиц пожилого возраста. При тяжелой почечной недостаточности рекомендуется снижение дозы или проведение прерывистого курса лечения. У пациентов с эпилепсией перед началом терапии необходимо провести предварительное клиническое и электрофизиологическое обследование, т.к. сульпирид понижает порог судорожной готовности. В случае появления гипертермии, которая является одним из элементов ЗНС, сульпирид следует немедленно отменить. В период лечения не допускать употребления алкоголя. С осторожностью применяют у детей. Влияние на способность к вождению автотранспорта и управлению механизмамиВ период лечения следует воздерживаться от занятий потенциально опасными видами деятельности, требующими повышенного внимания и быстрых психомоторных реакций.
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