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Information about Asenapine

Asenapine is a second generation (atypical) antipsychotic agent that is taken sublingually and used in the treatment of schizophrenia and manic or mixed episodes associated with bipolar 1 disorder.

Liver safety of Asenapine

Asenapine is associated with a low rate of transient and mild serum aminotransferase elevations during therapy, but has not been linked to instances of clinically apparent acute liver injury.

Mechanism of action of Asenapine

Asenapine (a sen' a peen) is a second generation antipsychotic agent which appears to act as a dopamine type 2 (D2) and serotonin (5-HT)-2A receptor antagonist. It is a somewhat unique antipsychotic agent that has a tetracyclic structure similar to that of mirtazapine, and it is administered as a sublingual tablet, being poorly absorbed by the oral route. Several randomized controlled trials have shown that sublingual asenapine improves symptoms of schizophrenia with effects comparable to risperidone and olanzapine. It also has beneficial activity in acute manic and mixed episodes associated with bipolar 1 disorder.

FDA approval information for Asenapine

Asenapine was approved for use in the United States in 2009 and is available in sublingual tablets of 2.5, 5 and 10 mg under the brand name Saphris.

Dosage and administration for Asenapine

The typical maintenance dose in adults is 2.5 to 10 mg twice daily.

Side effects of Asenapine

Common side effects of include dizziness, somnolence, fatigue, nausea, anxiety, restlessness (akathisia) and weight gain. Rare, but potentially severe adverse reactions (mentioned in most antipsychotic and antidepressant product labels) include tardive dyskinesia, major neurologic events, neuroleptic malignant syndrome, orthostatic hypotension, seizures, neutropenia, hypersensitivity reactions, prolongation of the QTc interval and suicidal ideation or behavior.

Antipsychotic agents

First Generation

Second Generation (Atypicals)

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