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Does A Higher Dosage Of Klonopin Interact With The Effects Of Solian?

Posted on Mon, 22 Jun 2015

Question: Hi,
I am on Klonopin 1 mg, Lexapro 2.5 mg, Solian 100 mg and Keppra 1000 mg. I have some "OCD like" symptoms (even if it's not exactly OCD) since my doctor changed from Keppra to Neurontin and it was difficult to go back to Keppra, maybe there is some problem between dompaminergic effect of amisulpride at low dosage and modulation of calcium channels with Keppra. I was without these "OCD like" symptoms when i was taking a higher dosage of Klonopin (2 mg) and Lexapro (5mg, i am mild metabolizer for cyp2c19 and cyp2d6), so i would like to know if Klonopin in a higher dosage (2 mg) can counteract the dopaminergic effect of Solian. Thanks beforehand

Answered by Dr. Shubham Mehta (1 hour later)

Brief Answer:
klonopin can counteract the effects of solian.

Detailed Answer:
Hello
Welcome here.

Solian at low doses (50-100mg) acts as partial dopamine agonist.

Klonopin is claimed to have antidopaminergic effects in most studies.

So, theoretically klonopin can counteract the effects of solian.

Hope this answers your query satisfactorily.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shubham Mehta (4 hours later)

Dear Dr.
I just would like to know if before Neurontin probably a good modulation of calcium channels because of Keppra was counteracting the dopaminergic effect of Solian. My problem was gone until there was a change from Keppra to Neuontin.
Thanks beforehand, XXXXXXX

Answered by Dr. Shubham Mehta (4 hours later)

Brief Answer:
keppra might counteract the dopaminergic activity of solian.

Detailed Answer:
Dear XXXXXXX

Theoretically, there is a possibility that keppra might counteract the dopaminergic activity of solian.

When we compare the mechanism of action of the two drugs;

Keppra- inhibits presynaptic calcium channels reducing neurotransmitter release and acting as a neuromodulator. Due to this action keppra might reduce dopamine release.

Solian- it binds selectively to dopamine D2/D3 receptors. Low doses of solian (50-100 mg) block presynaptic D2/D3 autoreceptors, thereby enhancing dopaminergic transmission.

This is a conceptually-derived explanation. I am not sure how much clinically significant is this.

Since your problem has reappeared after change of keppra to neurontin, this interaction might be the reason.

I appreciate such a technical questions from you.

Hope I am able to answer your query satisfactorily.

Take care.
Thanks.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj