Solian

Solian (amisulpride) is an atypical antipsychotic medication specifically engineered for the treatment of schizophrenia. It functions by selectively antagonizing dopamine D2 and D3 receptors in the brain, which helps to restore neurotransmitter balance and mitigate the positive and negative symptoms associated with this complex psychiatric disorder. Its high affinity for limbic rather than striatal receptors contributes to a favorable efficacy profile with a reduced propensity for extrapyramidal side effects compared to first-generation antipsychotics. Clinicians value Solian for its targeted action, which supports improved patient outcomes in both acute episodes and maintenance therapy.

Features

• Active Ingredient: Amisulpride
• Pharmacological Class: Benzamide derivative; atypical antipsychotic
• Mechanism of Action: Selective antagonist of dopamine D2 and D3 receptors
• Bioavailability: Approximately 48%
• Protein Binding: Low (16%)
• Metabolism: Minimally hepatic; excreted largely unchanged in urine
• Half-life: Approximately 12 hours
• Available Formulations: Film-coated tablets (50 mg, 100 mg, 200 mg, 400 mg)

Benefits

• Effectively reduces positive symptoms such as hallucinations, delusions, and thought disorder
• Demonstrates significant efficacy in alleviating negative symptoms including social withdrawal, apathy, and blunted affect
• Lower incidence of extrapyramidal symptoms and hyperprolactinemia compared to many typical antipsychotics
• Linear pharmacokinetics allow for predictable dosing and plasma concentrations
• Suitable for long-term maintenance therapy, aiding in relapse prevention
• May improve overall quality of life and social functioning in patients with schizophrenia

Common use

Solian is primarily indicated for the treatment of schizophrenia in adults. It is effective in managing both the acute psychotic phase and for maintenance therapy to prevent relapse. Its ability to address negative symptoms—often resistant to treatment with conventional antipsychotics—makes it a valuable option in comprehensive schizophrenia management. Off-label uses may include other psychotic disorders, though such applications should be carefully considered by a specialist based on individual patient profiles and clinical evidence.

Dosage and direction

Dosage must be individualized based on symptom severity, patient response, and tolerability.

• For positive symptoms: The recommended dose is 400–800 mg per day, administered in two divided doses. Doses above 400 mg per day do not generally confer additional benefit for positive symptoms but may increase the risk of adverse effects.
• For predominant negative symptoms: Lower doses, typically 50–300 mg per day, are often effective.
• Elderly patients: A lower starting dose is recommended due to potential renal impairment; dose adjustment based on creatinine clearance is advised.
• Patients with renal impairment: Dose reduction is necessary. Not recommended if creatinine clearance is below 10 mL/min.

Tablets should be swallowed whole with water, preferably before meals. Dosage adjustments should be made gradually under medical supervision.

Precautions

• Regular monitoring of renal function is advised before and during treatment.
• Use with caution in patients with cardiovascular disease, Parkinson’s disease, or epilepsy.
• May cause sedation; patients should be cautioned about operating machinery or driving until their response is known.
• Elevations in prolactin levels may occur; clinical monitoring for symptoms such as galactorrhea, amenorrhea, or gynecomastia is recommended.
• Not recommended during pregnancy unless clearly necessary; advise use of effective contraception in women of childbearing potential.
• Should not be used during breastfeeding.

Contraindications

• Hypersensitivity to amisulpride or any excipients in the formulation
• Phaeochromocytoma
• Prolactin-dependent tumours
• Concomitant use with levodopa
• Severe renal impairment (creatinine clearance <10 mL/min)

Possible side effects

Common (≥1/10):

• Insomnia, anxiety, agitation
• Hyperprolactinaemia (which may lead to galactorrhea, amenorrhea, erectile dysfunction)
• Weight gain

Uncommon (≥1/1,000 to <1/100):

• Extrapyramidal symptoms (e.g., akathisia, dystonia, tremor)
• Bradycardia, hypotension
• Constipation, nausea, dry mouth
• Rash

Rare (<1/1,000):

• QT prolongation
• Neuroleptic malignant syndrome
• Seizures
• Venous thromboembolism

Drug interaction

• Concomitant use with other central nervous system depressants (e.g., alcohol, benzodiazepines) may enhance sedative effects.
• May enhance the hypotensive effects of antihypertensive drugs.
• Levodopa and dopamine agonists: antagonistic effect; avoid concomitant use.
• Drugs that prolong the QT interval (e.g., certain antiarrhythmics, antipsychotics, antibiotics) should be used with caution due to additive risk.
• Amisulpride is primarily renally excreted; drugs that impair renal function may increase its plasma concentration.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not take a double dose to make up for a missed one.

Overdose

Symptoms may include severe sedation, coma, hypotension, and extrapyramidal symptoms. Management is supportive and symptomatic; there is no specific antidote. Gastric lavage may be considered if ingestion was recent. Cardiovascular monitoring is advised, particularly for QT prolongation. Ensure adequate hydration and maintain renal function.

Storage

Store below 30°C in the original packaging to protect from light and moisture. Keep out of sight and reach of children. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for healthcare professionals 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 treatment. Never disregard professional medical advice or delay in seeking it because of something you have read in this product card.

Reviews

Clinical studies and meta-analyses consistently demonstrate the efficacy of amisulpride in the treatment of both positive and negative symptoms of schizophrenia, with a tolerability profile that supports its use as a first-line atypical antipsychotic. Its distinct receptor profile offers a valuable option within the antipsychotic arsenal, particularly for patients with predominant negative symptoms or those intolerant to other agents. Long-term data support its role in maintenance therapy, though individual patient response and side effect profiles should guide treatment choices.