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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Stopping Neopride Total After 12 Years Cause Withdrawal Symptoms Like Severe Anxiety, And Is Rabitrack-L An Effective Alternative?

I had my hystectomy in 2009 and had a turbulent menopause symptoms I used to have panic anxiety attacks coupled with extreme acidity and gastric issues. I was put on neopride total by my doctor in 2010 and gradually my symptoms both anxiety attacks and acidity reduced. Unknowingly I have been continuing neopride total till last month That s for 12 years nearly. When I visited the doctor last month he asked me to stop neopride total as it may cause Parkinson disease. As soon as I stopped my anxiety attacks are back with a vengeance the doctor says it could be because of levosulpride constituent of the medicines I was having. He has advised Rabitrack l two times a day but I am feeling miserable please help me
posted on Tue, 1 Aug 2023
Twitter Tue, 21 Oct 2025 Answered on
Twitter Fri, 31 Oct 2025 Last reviewed on
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General & Family Physician,  's  Response
Hi,

What’s happening makes sense pharmacologically — Neopride Total (which contains Levosulpiride + Pantoprazole) has a mild dopamine-blocking action. When taken for years, your body adjusts to that balance, so sudden withdrawal can trigger rebound anxiety, restlessness, palpitations, and gastric flare-ups — especially if you had anxiety tendencies earlier. It’s not dangerous, but it can be extremely uncomfortable for a few weeks.

Your doctor is right to stop it though — long-term levosulpiride use does carry risks like movement disorders (Parkinsonism or tardive dyskinesia), especially beyond a few years.

Now regarding Rabitrack-L — that’s Rabeprazole + Levosulpiride, so it actually still contains the same dopaminergic component causing concern. If your doctor prescribed it short-term just to ease the transition, fine — but for the long term, it’s not really a clean alternative. If your anxiety and gastric issues are both back, the plan should be to:
1. Manage acidity with a plain PPI (like Rabeprazole alone or Pantoprazole) without Levosulpiride.
2. Ease withdrawal anxiety slowly — sometimes doctors use a mild anti-anxiety or SSRI temporarily, or taper the Levosulpiride instead of an abrupt stop.
3. Lifestyle: small frequent meals, avoid caffeine, do some breathing or light exercise to stabilize anxiety swings.

Your system has gotten used to the dopamine block even though you are not addicted in the usual way. After discontinuing it, generally one gradually feels better within 2–6 weeks, if they support it with a decent diet, good hydration, and avoidance of anxiety triggering situations. Talk to your doctor and gradually taper it or switching to a pure PPI. Also, a good anxiety management plan that doesn’t involve dopamine-blocking drugs will surely help. If you develop tremors, muscle stiffness, or severe panic that’s affecting sleep, reach out quickly — those are things to handle with a guided taper or alternate medication.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Usaid Yousuf, General & Family Physician
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Can Stopping Neopride Total After 12 Years Cause Withdrawal Symptoms Like Severe Anxiety, And Is Rabitrack-L An Effective Alternative?

Hi, What’s happening makes sense pharmacologically — Neopride Total (which contains Levosulpiride + Pantoprazole) has a mild dopamine-blocking action. When taken for years, your body adjusts to that balance, so sudden withdrawal can trigger rebound anxiety, restlessness, palpitations, and gastric flare-ups — especially if you had anxiety tendencies earlier. It’s not dangerous, but it can be extremely uncomfortable for a few weeks. Your doctor is right to stop it though — long-term levosulpiride use does carry risks like movement disorders (Parkinsonism or tardive dyskinesia), especially beyond a few years. Now regarding Rabitrack-L — that’s Rabeprazole + Levosulpiride, so it actually still contains the same dopaminergic component causing concern. If your doctor prescribed it short-term just to ease the transition, fine — but for the long term, it’s not really a clean alternative. If your anxiety and gastric issues are both back, the plan should be to: 1. Manage acidity with a plain PPI (like Rabeprazole alone or Pantoprazole) without Levosulpiride. 2. Ease withdrawal anxiety slowly — sometimes doctors use a mild anti-anxiety or SSRI temporarily, or taper the Levosulpiride instead of an abrupt stop. 3. Lifestyle: small frequent meals, avoid caffeine, do some breathing or light exercise to stabilize anxiety swings. Your system has gotten used to the dopamine block even though you are not addicted in the usual way. After discontinuing it, generally one gradually feels better within 2–6 weeks, if they support it with a decent diet, good hydration, and avoidance of anxiety triggering situations. Talk to your doctor and gradually taper it or switching to a pure PPI. Also, a good anxiety management plan that doesn’t involve dopamine-blocking drugs will surely help. If you develop tremors, muscle stiffness, or severe panic that’s affecting sleep, reach out quickly — those are things to handle with a guided taper or alternate medication. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Usaid Yousuf, General & Family Physician