Levosulpiride: a review of its clinical use in psychiatry

Levosulpiride is the (-)-enantiomer of sulpiride. It has shown greater central antidopaminergic activity, antiemetic and antidyspeptic effects and lower acute toxicity than both the racemic and dextro forms. Several clinical studies indicate that levosulpiride has therapeutic efficacy in depressive and somatoform disorders, as well as in schizophrenic patients with predominant negative features. All controlled studies report a low frequency of extrapyramidal and autonomic side-effects. The increase of plasma prolactin concentration is the major drawback of the use of the drug, but its frequency may be reduced by low dosage.