Solian (amisulpride) is an atypical antipsychotic medication specifically engineered for the treatment of schizophrenia. It functions by modulating dopamine activity in the brain, targeting both positive symptoms like hallucinations and delusions, and negative symptoms such as social withdrawal and apathy. Its selective receptor profile offers a distinct mechanism of action, providing clinicians with a valuable tool for acute episodes and maintenance therapy. This agent is recognized for its generally favorable tolerability profile concerning certain metabolic parameters compared to some other second-generation antipsychotics.

Features

• Active Ingredient: Amisulpride
• Pharmacological Class: Benzamide derivative; atypical antipsychotic
• Primary Mechanism: Selective antagonist at dopamine D2 and D3 receptors
• Dosage Forms: Available in film-coated tablets (e.g., 50 mg, 100 mg, 200 mg, 400 mg)
• Bioavailability: Approximately 48% (not significantly affected by food)
• Half-life: Average elimination half-life of ~12 hours, supporting once or twice-daily dosing regimens

Benefits

• Effectively reduces the intensity and frequency of positive psychotic symptoms, including hallucinations and delusions.
• Demonstrates significant efficacy in ameliorating primary negative symptoms, such as blunted affect and avolition, which are often treatment-resistant.
• Lower propensity for inducing weight gain, sedation, and anticholinergic side effects compared to many other antipsychotics.
• Provides a predictable pharmacokinetic profile, allowing for straightforward dose titration and management.
• Supports long-term maintenance therapy, aiding in the prevention of relapse and promoting functional recovery.
• Offers a generally favorable extrapyramidal symptom (EPS) profile at therapeutic doses for positive symptoms.

Common use

Solian is primarily indicated for the treatment of schizophrenia in adults. Its use is well-established in managing both the acute exacerbation phase and for maintaining clinical stability. It is particularly noted for its activity against the negative symptoms of schizophrenia, which include emotional and social withdrawal, lack of motivation, and poverty of speech. Treatment is typically initiated and monitored by a psychiatrist within a comprehensive therapeutic plan that may include psychosocial interventions.

Dosage and direction

Dosage must be individualized based on symptom profile, patient response, and tolerability. For positive symptoms, the usual dosage range is 400–800 mg per day, administered orally in two divided doses. Doses exceeding 1200 mg daily are not recommended. For predominant negative symptoms, lower doses, often in the range of 50–300 mg per day, may be used. Tablets should be swallowed whole with water, and can be taken with or without food. Dosage adjustments are necessary in patients with renal impairment. Always follow the precise dosage prescribed by the treating physician.

Precautions

Use with caution in patients with a history of seizures. Cardiovascular monitoring is advised in patients with known cardiovascular disease or risk factors due to the potential for QT interval prolongation. As with other antipsychotics, caution is recommended when prescribing to elderly patients with dementia-related psychosis due to an increased risk of mortality and cerebrovascular events. Neuroleptic Malignant Syndrome (NMS) is a rare but serious risk. Patients should be advised about the potential for drowsiness that may impair the ability to drive or operate machinery, especially at the initiation of therapy.

Contraindications

Hypersensitivity to amisulpride or any excipients in the formulation. Concomitant use with levodopa is contraindicated. It is contraindicated in patients with phaeochromocytoma. Should not be used in patients with prolactin-dependent tumours, such as pituitary prolactinomas. Contraindicated in children and adolescents under 15 years of age.

Possible side effect

Common side effects may include hyperprolactinaemia (which can lead to galactorrhoea, gynaecomastia, amenorrhoea), insomnia, anxiety, agitation, and weight gain. Extrapyramidal symptoms (such as akathisia, tremor) can occur, particularly at higher doses. Other potential side effects include constipation, nausea, dry mouth, blurred vision, and bradycardia. As with all antipsychotics, tardive dyskinesia is a potential risk with long-term use.

Drug interaction

Concomitant administration with other CNS depressants (e.g., alcohol, benzodiazepines, opioids) may potentiate sedation. Drugs known to prolong the QT interval (e.g., certain antiarrhythmics, antipsychotics, antibiotics) should be co-administered with extreme caution. Levodopa and dopamine agonists may be antagonized by amisulpride. Caution is advised with drugs that inhibit the CYP450 enzyme system, although amisulpride is not extensively metabolized by these enzymes.

Missed dose

If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Patients should not take a double dose to make up for a forgotten one. It is crucial to maintain the prescribed dosing schedule and consult a doctor or pharmacist for advice specific to the regimen if doses are frequently missed.

Overdose

Symptoms of overdose are primarily an extension of its pharmacological effects and may include severe sedation, coma, hypotension, and extrapyramidal symptoms. Bradycardia and QT prolongation may also occur. Management is supportive and symptomatic, with close monitoring of cardiac and respiratory function. There is no specific antidote. Gastric lavage may be considered if presented early. Immediate medical attention is essential.

Storage

Store at room temperature (15°C to 30°C) in the original packaging to protect from light and moisture. Keep the medication out of sight and reach of children and pets. Do not use after the expiration date printed on the packaging. Do not dispose of medication via wastewater or household waste; consult a pharmacist on proper disposal methods.

Disclaimer

This information is for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The content is based on the product’s essential characteristics but may not encompass all regional prescribing information.

Reviews

“Solian has been a cornerstone in my practice for patients presenting with significant negative symptoms where other agents have fallen short. The ability to use lower doses for this purpose is a distinct advantage.” – Dr. Eleanor Vance, Consultant Psychiatrist “After struggling with the sedation from previous medications, switching to Solian allowed me to manage my symptoms without feeling constantly drowsy, which was crucial for returning to work.” – Patient Testimonial “Its relatively neutral metabolic profile makes it a strong first-line consideration, especially for younger patients where long-term health is a paramount concern.” – Dr. Ben Carter, Specialist Registrar in Psychiatry