A second-generation antipsychotic

Amisulpride

A second-generation antipsychotic used for schizophrenia that can calm symptoms at higher strengths and lift negative symptoms at lower ones, with raised prolactin, heart-rhythm (QT) effects and movement side effects to watch.

What is Amisulpride?

Amisulpride is a second-generation (atypical) antipsychotic used to treat schizophrenia. It works on dopamine signalling in the brain and can ease both the 'positive' symptoms such as hallucinations and the 'negative' symptoms such as withdrawal. Key things to monitor include heart rhythm (QT interval), raised prolactin, and movement-related side effects, and it should never be stopped suddenly.

Class: Antipsychotics · Brands: Solian

Education and reference only. This is a plain-language guide to Amisulpride — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: Antipsychotics → Brands: Solian
Amisulpride (Antipsychotics) — Meds Global Health reference card with 2D molecular structure
Amisulpride — Antipsychotics. The image shows the active ingredient's 2D molecular structure.

What it is

Amisulpride is a second-generation, or atypical, antipsychotic. It is used to treat schizophrenia, a condition that can cause hallucinations, delusions and changes in thinking and motivation. In the UK it is sold as Solian and as a generic medicine.

How it works

Amisulpride works mainly by blocking certain dopamine receptors in the brain. Overactivity of dopamine is linked to symptoms such as hallucinations and delusions, so reducing it eases these symptoms. At lower strengths it can also help with the 'negative' symptoms of schizophrenia, such as low motivation and social withdrawal.

Company & origin

Originated / developed by: Developed by Sanofi and sold in the UK as Solian and as generic amisulpride..

Amisulpride is a second-generation (atypical) antipsychotic developed in France by Sanofi and used in the UK to treat schizophrenia.

What it treats

Conditions Amisulpride is used for

Schizophrenia & psychosisA serious mental illness where a person loses some contact with reality — treated with ant…

Practical use

How to take Amisulpride

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take it regularly as prescribed, at about the same time each day.
  • It can usually be taken with or without food.
  • Swallow the tablet whole with a drink of water.
  • Keep taking it even when you feel better, as stopping can let symptoms return.
  • If you miss a dose, take it when you remember unless it is nearly time for the next one; do not double up.
  • Never stop it suddenly without medical advice; the dose is usually reduced gradually.

Weighing it up

Advantages & disadvantages of Amisulpride

Advantages

  • Effective against both positive and negative symptoms of schizophrenia.
  • Tends to cause less weight gain than some other antipsychotics.
  • Can be helpful when low motivation and withdrawal are prominent.
  • A well-established treatment available as a generic medicine.

Disadvantages

  • Can prolong the heart's QT interval, affecting heart rhythm.
  • Frequently raises the hormone prolactin, which may cause breast changes or sexual side effects.
  • Can cause movement side effects such as stiffness, tremor or restlessness.
  • Must not be stopped suddenly and needs ongoing monitoring.
  • May cause drowsiness, especially when starting.

Practical use

Good to know

Amisulpride is taken regularly to keep symptoms under control, and the benefit builds over weeks rather than straight away. It should not be stopped suddenly, and you will have some health checks, including for heart rhythm and a hormone called prolactin.

Who should not take it / use with caution

  • People with certain heart-rhythm problems or a prolonged QT interval.
  • Anyone with a prolactin-dependent tumour, such as some breast or pituitary tumours.
  • People with a phaeochromocytoma (a rare adrenal tumour).
  • Older people with dementia, in whom antipsychotics carry extra risks.
  • Amisulpride is removed from the body mainly by the kidneys, so caution and a lower dose are needed if kidney function is reduced — it can build up and increase the risk of heart-rhythm (QT) problems.
  • People who are pregnant or breastfeeding should discuss it carefully with their doctor.

Monitoring

  • Heart rhythm (an ECG) and blood salts such as potassium where needed.
  • Prolactin level if symptoms such as breast changes or sexual problems develop.
  • Weight, blood sugar and blood pressure as part of routine antipsychotic checks.
  • Kidney function, as amisulpride is removed from the body mainly by the kidneys, so caution and a lower dose are needed if kidney function is reduced — it can build up and increase the risk of heart-rhythm (QT) problems.
  • Mental state and any new movement side effects at review appointments.

Side effects

  • Drowsiness, restlessness or difficulty sleeping.
  • Movement effects such as tremor, stiffness or muscle spasms.
  • Raised prolactin causing breast tenderness, milk production or sexual difficulties.
  • Weight changes, constipation or a dry mouth.
  • Rare but serious: changes in heart rhythm, or a reaction called neuroleptic malignant syndrome with high fever, stiffness and confusion needing emergency help.

Key interactions

  • Other medicines that prolong the QT interval, such as some antibiotics, antidepressants and other antipsychotics.
  • Medicines that lower potassium, such as some diuretics, which add to heart-rhythm risk.
  • Sedating medicines and alcohol, which add to drowsiness.
  • Levodopa and similar Parkinson's medicines, whose effects may be reduced.
  • Blood-pressure medicines, where the effect may be increased.

Available as: Tablets and an oral liquid (solution).

Answers

Amisulpride: frequently asked questions

How long does amisulpride take to work?

Some effects, such as feeling calmer, may come within days, but the full benefit on symptoms usually builds over several weeks of regular treatment.

Can I stop amisulpride once I feel better?

No, you should not stop suddenly. Stopping can cause symptoms to return and may cause withdrawal effects. Any change should be made gradually with your doctor.

Why does amisulpride affect prolactin?

By blocking dopamine, amisulpride can raise the hormone prolactin, which may cause breast tenderness, milk production or sexual side effects. Tell your doctor if these occur.

Why might I need an ECG with amisulpride?

Amisulpride can affect the heart's QT interval, so an ECG may be done to check your heart rhythm, especially if you have other risk factors.

Will amisulpride make me gain weight?

It tends to cause less weight gain than some other antipsychotics, but weight, blood sugar and other measures are still monitored during treatment.

The wider class

About Antipsychotics

Amisulpride belongs to the antipsychotics class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

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Authoritative sources

  • BNF
  • NICE CKS

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