Amisulpride

Amisulpride is an antipsychotic medication of the benzamide class used to treat schizophrenia in adults in many countries. It functions as a selective antagonist of dopamine D2 and D3 receptors, with a distinctive dose-dependent profile: at low doses it preferentially blocks limbic D2/D3 receptors, which is associated with effects on negative symptoms and mood, while at higher doses it blocks both limbic and cortical receptors, addressing positive psychotic symptoms.

It is typically prescribed for adults with schizophrenia, and dosing is individualized based on symptom profile. Low to moderate doses (often around 50 to 300 mg per day) may be used for predominant negative symptoms or depressive features, whereas higher doses (often in the range of several hundred milligrams per day, sometimes up to 600–1200 mg) are employed for positive symptoms. Treatment is usually started at a low dose and titrated. Amisulpride is not approved in the United States, but it is marketed in various other regions under brand names such as Solian.

Common adverse effects reflect its dopamine blockade, notably hyperprolactinemia, which can cause menstrual disturbances, galactorrhea, and reduced bone density over time. Extrapyramidal symptoms such as parkinsonism or akathisia may occur, especially at higher doses. Other potential effects include weight changes, sedation, and gastrointestinal discomfort. As with other antipsychotics, careful monitoring for movement disorders, metabolic changes, and prolactin-related effects is advised, along with caution in patients with renal impairment and when combining with other dopaminergic or QT-prolonging medicines.

Availability and regulatory status vary by country; in practice, clinicians consider amisulpride primarily for adults with schizophrenia and tailor dosing to balance efficacy with tolerability.