Amisulpride is a unique drug among SGAs. Whereas most of the other new generation antipsychotics have a high affinity for both dopamine and serotonin receptors, amisulpride is a selective dopamine receptor antagonist with high affinity

to D3 and D2 receptors [Scatton et al. 1997]. It is well established that amisulpride is at least Inhibitors,research,lifescience,medical as effective in the control of find more positive symptoms as conventional antipsychotic drugs and other SGAs [Möller, 2000; Burns and Bale, 2001]. At low doses amisulpride preferentially blocks presynaptic dopamine autoreceptors [Schoemaker et al. 1997] which leads to an enhancement of dopamine transmission and may explain why amisulpride was found to Inhibitors,research,lifescience,medical be more effective than placebo and conventional antipsychotics for patients with predominantly negative symptoms [Leucht et al. 2002]. In a recent meta-analysis, Leucht

and colleagues reported that amisulpride is more efficacious than conventional antipsychotics for overall efficacy [Leucht et al. 2009]. Antipsychotic medications have pronounced effects on hormone secretion which explain their endocrinologic side effects [Gründer Inhibitors,research,lifescience,medical et al. 1999]. Hyperprolactinemia is a commonly observed side effect of the conventional antipsychotics and some of the SGAs. These agents rely on their dopamine antagonistic properties to provide their antipsychotic effects. However, this also removes the brake on prolactin secretion, leading to hyperprolactinemia [Hummer

and Inhibitors,research,lifescience,medical Huber, 2004]. Normal prolactin levels in women and men are below 530 mIU/L (25 ng/ml) and 424 mIU/L (20 ng/ml) respectively, with the more commonly used assays. Hyperprolactinemia is usually simply defined as a sustained level of prolactin above the laboratory upper level of normal [Peveler et al. 2008]. Marked prolactin excess, which is above 2120 mIU/L (100 ng/ml), is commonly associated with hypogonadism, galactorrhea and amenorrhea. Inhibitors,research,lifescience,medical Moderate prolactin excess, which is between 1000 and 1600 mIU/L (51 and 75 ng/ml), may be associated with oligomenorrhea. Mild prolactin excess, which is below 1000 mIU/L (50 ng/ml), is associated with decreased libido and infertility [Serri et al. 2003]. Two of the SGAs, risperidone and amisulpride, have a significant prolactin elevating property more like those of the traditional variety [Stanniland and Taylor, 2000]. Kopecek and colleagues stated that subjects who receive amisulpride Oxalosuccinic acid doses as low as 50 mg/day have hyperprolactinemia in almost all cases that is significantly high (mean 113 ng/ml, 2400 mIU/L) and higher in females (160 ng/ml, 3400 mIU/L) than males (48ng/ml, 1000 mIU/L) [Kopecek et al. 2004]. Akkaya and colleagues reported hyperprolactinemia resulting in prolactin-secreting pituitary adenoma development with amisulpride treatment in three schizophrenic patients [Akkaya et al. 2009].