Amisulpride

Antipsychotic Drug

Drug class: Atypical Antipsychotic

Amisulpride (SOLIAN)（中文：氨磺必利）

Pronunciation

Amisulpride 100mg

Amisulpride 400mg

Common Strengths of Amisulpride Tablet

Amisulpride tablets are available in the following strengths:

• 100 mg, 200 mg, 400 mg tablets

Drug Trade Names of Amisulpride Tablet

Solian

Drug Usage

Amisulpride is used for:

• Treatment of schizophrenia

Mechanism of Action

Amisulpride is a selective dopamine D2 and D3 receptor antagonist. At low doses, it selectively binds to presynaptic dopamine autoreceptors, while at high doses, it preferentially binds to post-synaptic dopamine receptors. This explains its effectiveness in treating both negative and positive symptoms of schizophrenia.

Route of Administration

• Oral (tablets and oral solution)

Dosages

• Schizophrenia: 400 - 800 mg/day orally, divided into two doses.

Renal dose based on eGFR:

For severe renal impairment (eGFR <30 mL/min/1.73 m2): Use is not recommended

Side Effects

Frequency	Adverse reactions
Common	Drowsiness/sleepiness
	Weight gain
	Dizziness
	Increased appetite
	Nausea and vomiting
	Constipation
	Dry mouth
	Blurred vision
	Insomnia
	Anxiety and agitation
	Sexual problems (e.g. difficulty with orgasm)
	Excess saliva production
Uncommon	Unexplained infections
	Fast breathing
	Sweating
	High blood sugar (increased thirst, hunger, urination)
	Breast pain or milk production (in women)
	Menstrual changes
	Heart rhythm changes (QT prolongation)
	Low potassium levels
	Neuroleptic malignant syndrome (high fever, muscle rigidity, altered mental state)

Pharmacokinetics

• Onset Time
  • 1 to 4 hours after oral administration; immediate after IV administration.
• Metabolism
  • Amisulpride undergoes minimal metabolism
• Elimination
  • Amisulpride is primarily eliminated unchanged in the urine
  • The elimination half-life is approximately 12 hours
  • Duration of Action: Approximately 12 hours based on the elimination half-life, with sustained therapeutic effects for long-term treatment in chronic conditions like schizophrenia.

A person should begin to feel better within six weeks of starting antipsychotic medication.

However, it may take several months before they feel the full benefits.

Drug Precautions

Pregnancy

Insufficient data on use during pregnancy to establish risk

Breastfeeding

Contraindicated during breastfeeding

Children and Elderly

• Not recommended for use in children under 18 years old
• Should not be used to treat dementia-related psychosis in older adults due to increased risk of stroke and death
• May cause drowsiness, dizziness, and difficulty swallowing in elderly patients, increasing the risk of falls and choking

Renal Imapirment

Dose adjustments are necessary for patients with renal insufficiency.

QT Prolongation

Amisulpride can cause dose- and concentration-dependent prolongation of the QT interval, which can lead to serious ventricular arrhythmias like torsades de pointes. It should be avoided in patients with congenital long QT syndrome and those taking other drugs that prolong the QT interval (e.g., droperidol, ondansetron).

Abrupt Withdrawal

Should not be stopped abruptly to avoid withdrawal symptoms such as nausea, vomiting, insomnia, and the recurrence of psychotic symptoms

Monitoring Requirements

• Blood glucose monitoring as it may cause elevated blood glucose levels.
• ECG Monitoring: Recommended for patients with preexisting arrhythmias, cardiac conduction disorders, electrolyte imbalances (e.g., hypokalemia, hypomagnesemia), and congestive heart failure.

Drug Interaction

• Dopamine Agonists: Reciprocal antagonism with dopamine agonists (e.g., levodopa); concurrent use should be avoided.
• Other QT-Prolonging Drugs: Avoid coadministration with other drugs known to prolong the QT interval.

Contraindications

• Pheochromocytoma
• Prolactin-dependent tumors (e.g., prolactinoma, breast cancer)
• Movement disorders (e.g., Parkinson's disease, dementia with Lewy bodies)

FAQ

How Should I Take the Tablet?

Swallow the tablets whole with a full glass of water. Do not chew, crush or break the tablets

What should I avoid while taking?

• Amisulpride may cause drowsiness, dizziness or blurred vision, especially when you first start taking it. Avoid driving, operating machinery or doing activities that

require alertness until you know how the medication affects you.

• Do not stop taking amisulpride suddenly without consulting your doctor. Abrupt withdrawal can cause unpleasant side effects or a return of symptoms.

• Be cautious about getting overheated or dehydrated, as amisulpride can affect your body's ability to regulate temperature.

What Happens if I Miss a Dose?

Answer not provided in the given information. If you miss a dose, take it as soon as you remember. However, if it's almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.