Tiapride is a substituted
benzamide derivative with selective
dopamine D2-receptor antagonist properties which appears to have preferential affinity for extrastriatal
dopamine receptors. Animal and clinical studies show that
tiapride has
anxiolytic properties but the mechanism of action is uncertain. Results from limited studies indicate that the clinical efficacy of
tiapride in the treatment of agitation, aggressiveness, anxiety and
sleep disorders in the elderly appears superior to that of placebo,
chlorpromazine,
lorazepam and
meprobamate.
Tiapride also exerts a beneficial effect on vigilance and alertness in elderly patients and causes less sedation than
chlorpromazine.
Tiapride is well tolerated at the dosages recommended for elderly patients. Further well designed comparative studies with newer drugs are needed to determine the relative place of
tiapride in the treatment of geriatric agitation, and such studies should also address the quality-of-life benefits for the patient. Additional clinical experience to determine the efficacy of
tiapride in elderly patients with more than one disease condition, receiving concomitant medications, and/or with renal impairment is also required. However, despite these current limitations,
tiapride may have potentially important applications in this difficult area of clinical medicine.