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SGA / Selective D2/D3·Psychiatry - Oral Antipsychotics
Schizophrenia (both acute exacerbations and maintenance)
Max Dose
1200 mg/day
Half-life
12 h
Prolactin
HIGH RISK
Renal Adj.
DOSE RED.
Overview
Highly selective D2/D3 antagonist. Acts differently depending on the dose (low doses for negative symptoms, high doses for psychosis). Very low metabolic risk but causes profound hyperprolactinemia.
Maximum Dose
Max 1200 mg/day.
Clinical Focus
Unlike most antipsychotics which are cleared by the liver, Amisulpride is cleared almost entirely by the kidneys. Unadjusted doses in CKD cause severe toxicity.
Bottom Line
Amisulpride is a selective D2/D3 antagonist effective for both positive and negative symptoms of schizophrenia, but causes significant hyperprolactinaemia and requires renal dose adjustment.
Brand Names
Solian
Oral Routes
Tablets (100, 200, 400 mg). Oral liquid (100 mg/mL).
Prescribing & PBS
Authority Required (PBS).
Primary
Schizophrenia (both acute exacerbations and maintenance).
Clinical Place
Highly effective. Often ranked second only to Clozapine in efficacy for schizophrenia. Excellent for patients with prominent negative symptoms (apathy, anhedonia).