Amisulpride Treatment of Somatoform Disorders: Not Just Chronic Fatigue Kausik Goswami, MD, DPM, Sahoo Saddichha, BA, MBBS, DPM, MD,* and Santosh K. Chaturvedi, MD, FRCPsych Amisulpride has been used to treat psychotic disorders and more recently even chronic fatigue. We describe 2 cases with somatoform disorders and who responded to low-dose amisulpride. Keywords: amisulpride, somatoform disorders INTRODUCTION A recent article described the effectiveness of amisulpride in chronic fatigue syndrome. 1 As this study has shown, in addition to chronic fatigue syndrome, amisulpride in low doses is quite useful to treat somatic manifestations of psychiatric disorders and perhaps somatoform disorders. Lending support to this hypothesis, we would also like to add our experience of having treated 2 patients with somatoform disorder with low-dose amisulpride and who responded extremely well to this regime. CASE 1 The first patient was a 22-year-old single, educated, female with nil family history, premorbidly having anxious avoidant traits, and who was referred to us due to persistent upper gastrointestinal symptoms despite extensive investigations having ruled out any organic pathology. She received a diagnosis of undif- ferentiated somatoform disorder and was initially tried on an adequate regime of specific serotonin reuptake inhibitors (Paroxetine upto 37.5 mg over a period of 16 weeks). After poor response, she was empirically tried on amisulpride, started at 25 mg and built gradually upto 100 mg. She reported about three- fourths improvement in symptoms at follow-up over 6 months and was maintained on the same dosage. CASE 2 The second patient was a 36-year-old married lady with past history of 1 depressive episode and nil family history who was referred to us with complaints of persistent pain and tingling sensation in the neck region for the past 1 year. She was adequately inves- tigated with magnetic resonance imaging, which revealed no abnormalities. She was diagnosed as suffering from somatoform pain disorder, which did not respond to an adequate trial of escitalopram and amitryptiline. Other tricyclics were avoided due to apprehension regarding adverse effects. Drawing upon the success with use of amisulpiride in the earlier case, she was then started on amisulpride 25 mg to 100 mg, and she reported near remission at 1-year follow-up. DISCUSSION In an earlier report, substituted benzamides like sulpiride have been used selectively for the treatment of a variety of somatoform disorders. 2 We believe that use of amisulpride, which is another substituted benzamide, may therefore benefit patients with soma- toform disorders due to their unique mechanism of Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India. *Address for correspondence: Senior Resident, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India, 560029. E-mail: saddichha@gmail.com American Journal of Therapeutics 0, 000–000 (2012) 1075–2765 Ó 2012 Lippincott Williams & Wilkins www.americantherapeutics.com Copyright ª Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.