Solian (amisulpride) is a modern atypical antipsychotic medication specifically engineered for the treatment of schizophrenia and related psychotic disorders. It functions through a highly selective dopamine receptor antagonism, primarily targeting the D2 and D3 receptors in the mesolimbic pathway, which is instrumental in reducing positive symptoms such as hallucinations and delusions, while its action in the mesocortical pathway helps mitigate negative symptoms including social withdrawal and apathy. Its distinct receptor profile offers a favorable balance between clinical efficacy and a reduced propensity for extrapyramidal side effects compared to first-generation antipsychotics. Prescribed under strict medical supervision, Solian represents a cornerstone in long-term psychiatric care, aiming to restore functional capacity and improve quality of life for patients.

Features

• Active ingredient: Amisulpride
• Pharmaceutical form: Film-coated tablets (50 mg, 100 mg, 200 mg, 400 mg)
• Mechanism: Selective antagonist of dopamine D2 and D3 receptors
• High bioavailability (~48%) with dose-linear pharmacokinetics
• Renal excretion as primary elimination pathway
• Administration: Oral, with or without food

Benefits

• Effectively reduces both positive and negative symptoms of schizophrenia
• Lower incidence of extrapyramidal symptoms and hyperprolactinemia compared to some conventional antipsychotics
• Improves cognitive function and social engagement in stable patients
• Supports long-term remission and relapse prevention
• Enhances overall quality of life and daily functioning

Common use

Solian is primarily indicated for the treatment of acute and chronic schizophrenia in adults. It is also used in the management of other psychotic disorders where dopaminergic dysregulation is implicated. Its efficacy spans both the positive symptomatology (e.g., hallucinations, thought disorder) and negative symptomatology (e.g., affective flattening, avolition), making it a versatile agent in comprehensive psychiatric treatment plans. Off-label uses may include bipolar disorder and major depressive disorder, though these require careful clinical justification and monitoring.

Dosage and direction

Dosage must be individualized based on symptom profile, patient response, and renal function. For positive symptoms, the recommended dose ranges from 400 mg to 800 mg per day, administered in two divided doses. Doses exceeding 1,200 mg daily are not recommended. For predominant negative symptoms, lower doses (50–300 mg daily) may be effective. Tablets should be swallowed whole with water, and can be taken irrespective of meals. Dosage adjustments are necessary in patients with renal impairment. Regular clinical assessment is advised to optimize therapeutic outcomes.

Precautions

Use with caution in elderly patients, who may be more susceptible to adverse effects. Cardiovascular monitoring is recommended in patients with a history of cardiac conditions. Solian may impair alertness; patients should be advised against driving or operating machinery until their response is known. Regular hematological, hepatic, and renal function tests are advisable during prolonged therapy. Electrolyte imbalances should be corrected prior to initiation. Pregnancy and lactation require careful risk-benefit evaluation under specialist guidance.

Contraindications

Solian is contraindicated in patients with known hypersensitivity to amisulpride or any excipients in the formulation. It must not be used in combination with levodopa and dopamine agonists. Contraindications also include phaeochromocytoma, prolactin-dependent tumours, and severe renal impairment (creatinine clearance <10 mL/min). Concomitant use with other drugs that prolong QT interval is not recommended.

Possible side effects

Common side effects may include hyperprolactinemia (leading to galactorrhea, gynecomastia, menstrual disturbances), insomnia, agitation, anxiety, and weight gain. Extrapyramidal symptoms (such as akathisia, dystonia, or parkinsonism) may occur, though less frequently than with typical antipsychotics. Other potential adverse reactions include hypotension, tachycardia, QT prolongation, gastrointestinal disturbances, and elevated liver enzymes. Any signs of neuroleptic malignant syndrome (e.g., hyperthermia, muscle rigidity) require immediate discontinuation.

Drug interaction

Solian may interact with other central nervous system depressants (e.g., alcohol, benzodiazepines), potentially enhancing sedative effects. Concomitant use with drugs that prolong QT interval (e.g., certain antiarrhythmics, macrolide antibiotics) increases arrhythmia risk. Dopaminergic agents (e.g., levodopa) may antagonize Solian’s effects. Caution is advised with drugs that inhibit renal excretion or alter electrolyte balance. Always review the patient’s full medication list before prescribing.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to compensate for a missed one is not recommended.

Overdose

Symptoms of overdose may include severe sedation, hypotension, tachycardia, extrapyramidal symptoms, and QT prolongation. Management is supportive and symptomatic; there is no specific antidote. Gastric lavage may be considered if ingestion was recent. ECG monitoring is essential. Contact a poison control center or seek emergency medical attention immediately.

Storage

Store below 30°C in the original packaging to protect from light and moisture. Keep out of reach of children and pets. 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. Never disregard professional medical advice or delay in seeking it because of something you have read in this document.

Reviews

Clinical studies and post-marketing surveillance indicate that Solian is effective in managing schizophrenia with a generally acceptable tolerability profile. Many clinicians appreciate its efficacy against negative symptoms and its relatively lower risk for metabolic side effects compared to some other atypical antipsychotics. Patient-reported outcomes often highlight improved motivation and social functioning. However, hyperprolactinemia remains a notable concern in long-term use. Always consider individual patient factors and response when selecting therapy.