Several studies have examined the efficacy and adverse effects of amisulpride for patients with schizophrenia, and these studies have been included in several meta-analyses (including network meta-analyses). The results show that amisulpride considerably reduces the characteristic symptoms of schizophrenia. However, the differences with other antipsychotics are small. The findings also show that significantly fewer people discontinue the treatment with amisulpride because of adverse effects or lack of effect than with placebo and most other antipsychotics. The adverse effects profile appears to be mild. Although the studies into amisulpride have some shortcomings, it appears that amisulpride for the treatment of schizophrenia is effective and has a mild adverse effects profile. The currently available studies do not, however, allow an unequivocal conclusion to be drawn. Ge-Bu therefore gives this drug a rating of +/-.
Pill verdict: +/- moderate
- The various antipsychotics (except clozapine) have comparable efficacy and effectivity, but differ considerably as regards their adverse effects.
- Studies of amilsulpride, which has been around for a long time but has only recently been authorised in the Netherlands, have shown it to be efficacious and effective and having a mild adverse effects profile, but the quality of the studies is open to criticism.
- Amisulpride is currently 2.5 to 100 times as expensive as other antipsychotics, which is a reason to regard it as a drug of second choice.
- Silveira da Mota Neto JI, Soares BG, Silva de Lima M. Amisulpride for schizophrenia. Cochrane Database Syst Rev. 2002;2002(2):CD001357. doi: 10.1002/14651858.CD001357.
- Komossa K, Rummel-Kluge C, Hunger H, Schmid F, Schwarz S, Silveira da Mota Neto JI, et al. Amisulpride versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD006624. doi: 10.1002/14651858.CD006624.pub2.
- Huhn M, Nikolakopoulou A, Schneider-Thoma J, Krause M, Samara M, Peter N, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet. 2019 Sep 14;394(10202):939-951. doi: 10.1016/S0140-6736(19)31135-3
- Johnsen E, Kroken RA, Løberg EM, Rettenbacher M, Joa I, Larsen TK, et al. Amisulpride, aripiprazole, and olanzapine in patients with schizophrenia-spectrum disorders (BeSt InTro): a pragmatic, rater-blind, semi-randomised trial. Lancet Psychiatry. 2020 Nov;7(11):945-954. doi: 10.1016/S2215-0366(20)30341-2.
- Pillinger T, McCutcheon RA, Vano L, Mizuno Y, Arumuham A, Hindley G, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry. 2020 Jan;7(1):64-77. doi: 10.1016/S2215-0366(19)30416-X.
- Informatorium Medicamentorum. Den Haag: KNMP, 2020. Available from: https://www.knmp.nl/producten/knmp-kennisbank.
- Stolk LM. Netwerk meta-analyse van geneesmiddelen. Gebu. 2020;54(8):89-95.
- Kahn RS, Fleischhacker WW, Boter H, Davidson M, Vergouwe Y, Keet IP, et al. EUFEST study group. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet. 2008 Mar 29;371(9618):1085-97. doi: 10.1016/S0140-6736(08)60486-9.
- Nederlandse Vereniging voor Psychiatrie. Multidisciplinaire richtlijn schizofrenie. 2012.
- CBG-MEB Geneesmiddeleninformatiebank. Samenvatting van de productkenmerken. Available from: https://www.geneesmiddeleninformatiebank.nl/smpc/h122730_smpc.pdf.
- KNMP. G-Standaard januari 2021.
- McKeage K, Plosker GL. Amisulpride: a review of its use in the management of schizophrenia. CNS Drugs. 2004;18(13):933-56. doi: 10.2165/00023210-200418130-00007.
- Tan N, van Os J. Schizofreniespectrum en andere psychotische stoornissen in de DSM-5 [The schizophrenia spectrum and other psychotic disorders in the DSM-5]. Tijdschr Psychiatr. 2014;56(3):167-72. Dutch. PMID: 24643825.
- Schoemaker J.. Methods for efficient drug development in neuropsychiatric diseases. Academisch proefschrift 2018. Available from: https://research.tilburguniversity.edu/en/publications/methods-for-efficient-drug-development-in-neuropsychiatric-diseas.
- Matilla TK. Bridging from drug registration trials to meaningful clinical evidence: the case of schizophrenia. Academisch proefschrift 2016. Available from: https://hdl.handle.net/11245/1.536192.
- van Os J, Kahn R. Remissiecriteria voor de diagnose schizofrenie [Remission criteria in schizophrenia]. Tijdschr Psychiatr. 2007;49(1):21-6. Dutch. PMID: 17225202.
- Andreasen NC, Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005 Mar;162(3):441-9. doi: 10.1176/appi.ajp.162.3.441.
- Leucht S. Measurements of response, remission, and recovery in schizophrenia and examples for their clinical application. J Clin Psychiatry. 2014;75 Suppl 1:8-14. doi: 10.4088/JCP.13049su1c.02.
- Overall JE, Gorham DR. The brief psychiatric rating scale. Psychological Reports 1962;10(3):799-812. Available from: https://doi.org/10.2466/pr0.19188.8.131.529.