Schizophrenia is called polymorphic endogenous mental disorder or a group of mental disorders that are associated with the instability of emotional reactions, the decay of the processes of perception and thinking, as well as a reduced or inadequate affect. The most frequently observed manifestations of this disease are fantastic or paranoid delusions, auditory pseudo-hallucinations, disorganized thinking and speech, social dysfunction and impaired performance.
In the treatment of schizophrenia, cognitive-behavioral, family and occupational therapy, as well as social rehabilitation, are used. It should be noted that the main role in the treatment of the aforementioned disease is played by the use of medicines.
What is the Solian drug? Instructions for use, reviews report that it is a very good and effective antipsychotic and antipsychotic drug. How this medicine works, whether it has any contraindications and how it should be used will be described later.
Composition, packaging and form of the medication
"Solian" - tablets, round and flat, white or almost white, having the engraving "AMI 100" ("AMI 200", "AMI 400") on one side and dividing the risk on the other.
The active substance of the drug in question is amisulpride. Also, the composition of the drug includes auxiliary ingredients in the form of sodium carboxymethyl starch, lactose monohydrate, hypromellose, MCC and magnesium stearate.
All tablets are placed in blisters of 10 pieces and packaged in cardboard packs.
Drug action
What determines the effective action of the drug "Solian"? Instructions for use, expert reviews report that the antipsychotic in question is a good antipsychotic drug due to its active component - amisulpride, which belongs to the group of substituted benzamides.
The action of this substance is associated with its predominant and selective affinity for receptors (dopaminergic) of the limbic system (D2 and D3). At the same time, amisulpride does not have affinity for serotonin and other neuroreceptors, including adrenergic, histamine and cholinergic.
In the course of laboratory studies on animals, it was proved that as a result of using high doses, amisulpride is able to block (to a greater extent) dopaminergic neurons located in the mesolimbic system, and similar neurons located in the striatum system (to a lesser extent).
When taking the “Solian” antipsychotic in low doses, its active substance blocks mainly presynaptic D2 and D3 dopaminergic receptors. This effect helps to significantly suppress the negative symptoms of schizophrenia.
Pharmacokinetic characteristics
After taking Solian, 2 peaks of absorption of its active ingredient are observed inside. One of them is reached after 60 minutes, and the second in the interval between 3 and 4 hours after taking the medicine.
The absolute bioavailability of the drug is 48%.
Carbohydrate-rich foods can lower T max , AUC, and C max of the main substance, while foods rich in fats do not cause any changes.
Due to the low degree of binding of amisulpride to plasma proteins (about 16%), its interaction with other drugs at the level of protein binding is not expected. Course use of the drug does not cause cumulation of its active component.
Amisulpride is metabolized in the liver to a small extent (approximately 4%). In this case, 2 inactive metabolites are identified.
The half-life of amisulpride is about 12 hours. The active substance is excreted unchanged together with urine.
Pharmacokinetic characteristics in special cases
According to the attached instructions, "Solian" should be used with caution in case of renal failure, since the systemic clearance in patients with such a pathology is significantly reduced. In addition, experience with the medication in question for the disease is limited. However, there is no information on taking amisulpride in a dosage exceeding 50 mg.
The active substance of the drug is practically not excreted by hemodialysis.
Judging by the reviews of doctors, Solian in patients with hepatic insufficiency does not accumulate in the liver, so a decrease in its dosage in such people is not required.
In what cases is it used?
What are the indications for use of the drug "Solian"? Reviews of experts indicate that this drug is effective in schizophrenia of acute and chronic course, including accompanied by negative and productive symptoms. Such a medication is often prescribed to patients who have delusions, affective flatness, hallucinations, loss of social and emotional connections, and mental disorders.
Contraindications
When can’t you use Solian tablets? Reviews of doctors indicate the following prohibitions on the use of the drug:
- severe renal failure;
- pheochromocytoma;
- concomitant use with dopamine receptor agonists (except for people with Parkinson's disease);
- combined administration with Levodopa, Bromocriptine, Amantadine, pramipexole, apomorphine, Entacapone, Lizurid, pergolid, ropinerol, Pyribedil and Selegilin;
- concurrent administration with drugs that can extend the QT interval and cause heart rhythm disturbance.
What other contraindications does the medication in question have? According to experts, there are the following conditions prohibiting the use of Solian:
- prolactin-dependent tumors (for example, breast cancer, pituitary prolactinoma, etc.);
- minor age;
- lactase deficiency, galactosemia, as well as alactose / glucose malabsorption syndrome;
- period of breastfeeding;
- high sensitivity of the patient to amisulpride or other components of the drug.
Cautious use of the drug
In what cases is careful use of Solian tablets provided? Reviews of experts report that the drug in question should be prescribed with caution to patients with:
- congenital elongated QT;
- development factors of ventricular arrhythmias, including ventricular tachycardia;
- bradycardia less than 55 beats per minute;
- acquired prolongation of the QT period, including when combined with drugs that increase the duration of this period;
- electrolyte disorders, including with hypokalemia;
- renal failure (due to the risk of cumulation of the drug);
- risk factors for stroke;
- risk factors for thromboembolism;
- concomitant therapy with drugs that can cause hypokalemia, slow intracardiac conduction and develop severe bradycardia;
- epilepsy (due to a possible decrease in the threshold of convulsive readiness);
- Parkinson's disease (due to a possible increase in symptoms of Parkinson's disease);
- diabetes mellitus;
- risk factors for diabetes (due to an increase in blood glucose).
It should also be noted that the antipsychotic under consideration is prescribed with special care to patients with dementia and elderly people, since they have a high predisposition to lower blood pressure and the possible development of a sedative effect.
Dosage of the drug "Solian". Instructions for use
In the event that the daily dosage of antipsychotic does not exceed 400 mg, then it is allowed to take it once a day. If the dose prescribed by the doctor is higher than indicated, then it must be divided into two doses.
In the presence of negative symptoms of schizophrenia, the recommended daily dosage of the drug varies between 50-300 mg. The selection of therapeutic doses is carried out only by an individual specialist.
How should mixed medications (with productive and negative symptoms) take Solian? Reviews of experts report that in this case, the drug must be selected so as to provide maximum control over the productive signs of the disease, that is, on average, the dose should be in the range of 400-800 mg per day. In this case, maintenance therapy is set individually at the level of the minimum possible effective doses (depends on the patient's response).
At the very beginning of the treatment of acute psychotic episodes, 400-800 mg of the drug per day is required.
The maximum daily dosage of the drug should not be higher than 1200 mg.
To maintain therapy, the dose selected by a specialist should be maintained or adjusted depending on the patient's response. In any case, the maintenance dosage is set individually at the lowest possible dose level.
With renal failure, the dosage of the drug is reduced by half or three times.
The safety and effectiveness of the drug in minors have not been established, therefore, in this case, the medication is contraindicated.
Side effects
What side effects does the Solian antipsychotic cause? Patient reviews report the following conditions that occur after taking the drug:
- Tremor, insomnia, stiffness, anxiety, hypokinesia, orgasm disorder, agitation.
- Hypersalivation, daytime drowsiness, akathisia, spasmodic torticollis, dyskinesia, acute dystonia, seizures, oculorigid crises, late dyskinesia trismus.
- Malignant antipsychotic syndrome, nausea, decreased blood pressure, gynecomastia, bradycardia, constipation, amenorrhea, vomiting.
- Prolongation of the QT period, dry mouth, ventricular rhythm disturbances, increased activity of liver enzymes, erectile dysfunction, increased prolactin levels (Solian in this case, it is necessary to cancel or reduce the dosage).
- Galactorrhea, ventricular polymorphic tachycardia, pain in the mammary glands, allergic reactions, weight gain.
- Neutropenia, hyperglycemia, agranulocytosis, venous thromboembolic complications, angioedema, pulmonary thromboembolism, urticaria, deep vein thrombosis, leukopenia.
Overdose cases
What negative reactions occur in patients with an overdose of Solian? Patient reviews report symptoms such as drowsiness, arterial hypotension, and sedation. Also, some experts argue that with an increased intake of antipsychotics, a person may experience a coma or death, especially when the medicine is combined with other psychotropic drugs.
To eliminate cases of overdose, it is necessary to maintain and control all the vital functions of the body. In this case, ECG monitoring is mandatory, since there is a high risk of lengthening the QT period and the development of life-threatening heart rhythm disturbances.
Similar drugs
What can replace a neuroleptic such as Solian? The analogues of this medicine are Solex and Soleron. Also, Rispaxol, Finlepsin, Klozasten, Eglonil, Moditen Depot, Leponex, Egolanza, Thioridazine are referred to drugs with similar clinical effects.
It must be remembered that it is permissible to use all of the above analogues only after consultation with the treating doctor.
It's important to know!
Taking the drug "Solian", the following should be considered:
- The simultaneous use of drugs with antihypertensive drugs, including beta-blockers (for example, “Metoprolol”, “Carvedilol” or “Bisoprolol”), increases the risk of hypotension.
- When taking “Soliana” in parallel with medicines that depress the central nervous system (for example, with antitussive drugs, analgesics, barbiturates, hypnotics, morphine derivatives, benzodiazepines, antidepressants with a sedative effect), there is an increase in the inhibitory effect of the antipsychotic on the central nervous system, and decreased (sharp) concentration of attention. The latter is especially dangerous for people whose activities require increased attention (for example, drivers of vehicles).
The drug "Solian": reviews of patients and specialists
According to experts, after the use of amisulpride in patients with acute schizophrenia, a noticeable decrease in secondary negative signs of the disease can be observed. Moreover, the incidence of extrapyramidal symptoms is more than halved.
Doctors report that when taking Solian, as well as when taking other antipsychotics, the patient may have a malignant antipsychotic syndrome. Among adverse reactions, a potentially fatal complication is especially often manifested, which is characterized by muscle stiffness, hyperthermia, autonomic disorders and an increase in the level of CPK.
If the development of hyperthermia is observed against the background of the use of antipsychotics, then it should be urgently canceled. Doctors also warn that it is forbidden to take alcohol and any drugs containing ethanol during amisulpride therapy.
Patients with diabetes indicate that the drug in question can cause an increase in blood glucose. Therefore, you should constantly monitor this indicator.
Some reviews of Solian say that with a sharp cessation of its intake (especially at high dosages), withdrawal syndrome occurs.
When using amisulpride, involuntary motor disorders such as akathisia, dyskinesia, and muscle tone disturbance may develop. In this regard, experts recommend reducing the dose when discontinuing the drug gradually.
In general, reviews of the Solian antipsychotic are predominantly favorable. Patients claim that already several doses of the drug give a positive result (delirium disappears, hallucinations). Although it cannot be said that many women taking such pills noted the development of completely different side effects. For example, some patients report that after a course of treatment they developed apathy and also gained weight.