Schizophrenia is a severe mental illness characterised by a mixture of symptoms such as hallucinations, delusions, disorganisation and social withdrawal. For some it can be a life-long condition and people with this diagnosis are usually treated with antipsychotic drugs. There can be quite a large difference in cost between recently developed antipsychotics (second generation) and the older ones (first generation), but the older drugs can have considerably more movement side effects and many people find them difficult to tolerate. In developing countries cost of medication can be a major factor in prescribing, so the first generation drugs are used the most.
Sulpiride is a first generation antipsychotic which is said to cause fewer adverse effects. In addition, people whose main symptoms are aspects of social withdrawal may respond better to sulpiride than some of the other older antipsychotics. This review reports trials comparing sulpiride with placebo for people with schizophrenia or similar psychotic illnesses. The two studies contained a total of 113 people with chronic (long term) schizophrenia, were both 12 weeks long and set in hospital. Most of the data from these trials were not reported in a way that would give meaningful statistics. However, in one trial sulpiride was not significantly better than placebo in improving negative symptoms (when measuring all such symptoms). However, the single negative symptom of the social behaviour of the participant, showed a significant improvement in the sulpiride group. The potential side effects of the medication were not measured, but the number of people leaving the trial early was not significantly different between the two groups. Sulpiride is an inexpensive antipsychotic drug that is used all over the world, therefore a well planned, conducted and reported randomised control trial would contribute to our knowledge about this drug.
(Plain language summary prepared for this review by Janey Antoniou of RETHINK, UK www.rethink.org).