Administration of Tiapridal (Tiapride)
Tiapridal (tiapride) can be administered orally as tablets (typically 100 mg), or parenterally via intramuscular or intravenous routes, with dosing typically ranging from 100-300 mg per day divided into 2-3 doses depending on the indication.
Oral Administration
- Standard dosing: 100-300 mg daily, typically divided into 2-3 doses (½ to 1 tablet, three times daily) 1
- For elderly patients: Lower starting doses are recommended due to increased sensitivity
- Tablets should be taken with or without food
- Maximum daily dose should not exceed 400 mg in most cases
Parenteral Administration
- Intramuscular (IM): Can be administered as deep IM injection
- Intravenous (IV): Can be given as slow IV injection or diluted IV infusion
- Parenteral administration should be used with caution due to small risk of neuroleptic malignant syndrome 2
Dosing Considerations by Patient Population
Elderly Patients
- Reduced starting doses recommended
- More susceptible to side effects, particularly sedation
- Despite this concern, tiapride has shown relatively good tolerability in elderly patients with less cognitive impairment compared to benzodiazepines 3
Patients with Renal/Hepatic Impairment
- Dose reduction recommended
- More frequent monitoring for adverse effects
Indications and Specific Dosing
Agitation and aggressiveness in elderly:
- Typically 100-300 mg daily in divided doses
- Well-tolerated in elderly populations with minimal cognitive effects 3
Alcohol withdrawal management:
- 300 mg daily, under medical supervision
- Should be accompanied by adjunct therapy for hallucinosis and seizures in severe cases 2
Dyskinetic disorders:
- For dyskinetic forms of cerebral palsy in children: Mean dose of 11.4 mg/kg/day in three divided doses has shown clinical improvement 4
Pharmacological Properties
- Selective dopamine D2 and D3 receptor antagonist 5
- Shows preferential activity at receptors previously sensitized to dopamine
- Lower propensity for causing catalepsy and sedation compared to typical neuroleptics 5
Monitoring and Precautions
- Monitor for extrapyramidal symptoms, particularly with higher doses
- Somnolence is the most common side effect (reported in approximately 17% of patients) 1
- Unlike benzodiazepines, tiapride has minimal effects on vigilance and low potential for interaction with alcohol 2
- Long-term use requires monitoring for potential tardive dyskinesia risk 2
Advantages Over Other Agents
- Well-tolerated, especially in debilitated patients, alcoholics, and the elderly 1
- Does not significantly impair cognitive function or memory 3
- Has shown effectiveness in cases resistant to other therapies (reported 66% effectiveness in resistant headaches) 1
Tiapride's unique pharmacological profile makes it particularly useful in elderly patients where sedation and cognitive impairment are concerns, though appropriate dose adjustment and monitoring remain essential.