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Suggest Alternative Medicines For Solian

Posted on Mon, 2 Mar 2015

Question: I am on Lexapro 50 mg, Klonopin 2 mg, Keppra 1500 and Solian (amisulpride) 100mg, all this for some obsessions caused by Solian because of agonism at low dosage on 5HT7 and 5HT2b receptors and some dopaminergic activity. I am not exactly diagnosed with OCD, it's just an image (windows of cars that i look often to) without any reaction in the body or special reaction of anxiety. It looks like OCD symptom, but it can be caused by Solian probably. My psychiatrist sometimes thinks than rather than a higher dosage of Lexapro, it's better to try old antipsychotic, since others new like Abilify or Sertindole don't work with me (i am probably mild metabolizer for cyp2d6 and poor for cyp2c19). I've been told that for example perphenazine can be a good alternative, or some other old antipsychotics. I would like to know about this and about an equivalency in perphenazine for Solian 100mg. The switch can be difficult?
Thanks beforehand

Answered by Dr. Shubham Mehta (59 minutes later)

Brief Answer:
rough equivalence perphenazine 4mg=solian 100mg.

Detailed Answer:
Hello
Welcome here.

I can understand your concerns.

In my opinion, perphenazine is not a good choice. The most important reason is tendency of perphenazine to cause long term side effects like akathisia and tardive dyskinesias.

If the use of antipsychotic is to be considered, I would personally prefer risperidone or olanzapine. You can discuss this with your doctor.

The dose equivalent of older and newer antipsychotic is difficult to calculate. However a rough equivalent dose would be solian 100=perphenazine 4mg.

I donot think switch should be difficult. There are no withdrawal effects of solian.

Hope this answers your query satisfactorily.

Feel free to ask further.
Kindly close the discussion if you are satisfied with responses and give your valuable feedback.

Thanks

Dr. Shubham Mehta, MD(Psychiatry).

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

Follow up: Dr. Shubham Mehta (16 hours later)

Thank you very much for your clear answer. I just would like to know the equivalence of olanzapine for Solian 100mg to discuss alternatives with my doctor, if olanzapine at low dosage cannot cause too much weight gain.
Thanks beforehand, XXXXXXX

Answered by Dr. Shubham Mehta (3 hours later)

Brief Answer:
olanzapine 2.5-5mg should sufficiently replace solian 100mg.

Detailed Answer:
Glad that you found my answer helpful.

I think olanzapine 2.5mg-5mg should sufficiently replace solian 100mg.

Yes, there are risks of weight gain with olanzapine but low doses are relatively safer. Also, the side effect of weight gain is reversible as compared to tardive dyskinesia (irreversible) caused by perphenazine.

Please discuss this with your doctor.

Kindly close the discussion if you are satisfied with the responses and give your valuable feedback.

You can also ask a direct query at your convenience, if you wish to discuss further.

Thanks.
Take care.

Thanks.
Dr. Shubham Mehta, MD (Psychiatry).

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E