the Side Effects of Sulpiride: Impact on Menstrual Cycle

The side effects of the medication sulpiride include: 1. Drowsiness or sedation 2. Weight gain 3. Extrapyramidal symptoms

My girlfriend is 19 years old.
In late February, she visited a psychiatrist because she has depression.
The doctor prescribed a medication called Sulpiride (Surin).
The doctor mentioned that if she experiences breast swelling or other issues after taking the medication, she should stop taking it immediately.
Her last menstrual period was around February 12, and her cycle is approximately 32 days.
After starting the medication, she experienced breast swelling as a side effect and stopped taking it right away.
However, her period has not arrived yet this month, and there are no signs that it is coming (usually, she experiences noticeable breast swelling about a week to ten days before her period).
The doctor mentioned that it is likely her period may not come this time.
What are the side effects of this medication? Can it disrupt her menstrual cycle? Could it delay or advance ovulation? Or is it possible, as the doctor suggested, that her allergic constitution is causing her period to be absent this month? Could you please provide detailed information about the side effects of this medication? Thank you.

dison, 20~29 year old female. Ask Date: 2005/03/17

Dr. Liu Huiya reply Pharmacology

Dear Dison,
One of the common side effects of taking Sulpiride is an increase in prolactin levels in the blood, which may lead to irregular menstruation and amenorrhea in women.
Prolactin is secreted by the pituitary gland and plays a crucial role in milk production, as well as having inhibitory functions.
When prolactin levels are excessively high, it can lead to difficulties in ovulation and, in severe cases, disrupt the menstrual cycle and affect the secretion of other hormones.
Since treatment for depression typically requires medication for more than six months, if you experience the aforementioned amenorrhea, it is advisable to discuss switching to another medication with your physician.
If Sulpiride is effective and you wish to continue its use, an alternative approach to mitigate the increase in prolactin levels can be considered.

Thank you for your letter, and I wish you well!

Reply Date: 2005/03/17

More Info

Sulpiride, known as "舒立寧" in Chinese, is an atypical antipsychotic medication primarily used to treat depression and anxiety disorders. While it can be effective in managing these conditions, it is important to be aware of its potential side effects, particularly regarding menstrual cycles and reproductive health.

One of the notable side effects of sulpiride is its impact on the endocrine system, particularly through its action on dopamine receptors. Sulpiride can increase prolactin levels in the body, a hormone that plays a crucial role in lactation and has various effects on the menstrual cycle. Elevated prolactin levels can lead to menstrual irregularities, including delayed menstruation, amenorrhea (absence of menstruation), or changes in the menstrual cycle's regularity. This is likely what your girlfriend is experiencing, especially since she has reported breast swelling, which is another symptom associated with increased prolactin levels.

In terms of the menstrual cycle, sulpiride can disrupt the normal hormonal balance. It may inhibit ovulation, leading to irregular cycles or delayed periods. The absence of premenstrual symptoms, such as breast tenderness, can also indicate that ovulation may not have occurred, which is consistent with the hormonal changes induced by sulpiride.
It is essential to note that while sulpiride can cause these side effects, individual responses to medication can vary significantly. Factors such as overall health, other medications, stress levels, and lifestyle can also influence menstrual cycles. If your girlfriend has a history of allergies or sensitivities, it is possible that her body is reacting differently to the medication, but the hormonal effects of sulpiride are more likely the primary cause of her menstrual irregularities.

If she has stopped taking sulpiride due to the side effects, it is advisable to consult with her healthcare provider. They may recommend monitoring her menstrual cycle for a few months to see if it normalizes after discontinuation of the medication. In some cases, it may take time for hormone levels to stabilize and for regular menstrual cycles to resume.
In summary, sulpiride can indeed disrupt the menstrual cycle due to its effects on prolactin and overall hormonal balance. If your girlfriend continues to experience irregularities or if her period does not return in a reasonable timeframe, it is crucial for her to seek medical advice. Her healthcare provider may consider alternative treatments for her depression that have a lower risk of affecting her menstrual cycle. Open communication with her doctor about all side effects and concerns is vital for her health and well-being.

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