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2015 ; 11
(ä): 3007-17
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Asenapine for bipolar disorder
#MMPMID26674884
Scheidemantel T
; Korobkova I
; Rej S
; Sajatovic M
Neuropsychiatr Dis Treat
2015[]; 11
(ä): 3007-17
PMID26674884
show ga
Asenapine (Saphris(®)) is an atypical antipsychotic drug which has been approved
by the US Food and Drug Administration for the treatment of schizophrenia in
adults, as well as the treatment of acute manic or mixed episodes of bipolar I in
both adult and pediatric populations. Asenapine is a tetracyclic drug with
antidopaminergic and antiserotonergic activity with a unique sublingual route of
administration. In this review, we examine and summarize the available literature
on the safety, efficacy, and tolerability of asenapine in the treatment of
bipolar disorder (BD). Data from randomized, double-blind trials comparing
asenapine to placebo or olanzapine in the treatment of acute manic or mixed
episodes showed asenapine to be an effective monotherapy treatment in clinical
settings; asenapine outperformed placebo and showed noninferior performance to
olanzapine based on improvement in the Young Mania Rating Scale scores. There are
limited data available on the use of asenapine in the treatment of depressive
symptoms of BD, or in the maintenance phase of BD. The available data are
inconclusive, suggesting the need for more robust data from prospective trials in
these clinical domains. The most commonly reported adverse effect associated with
use of asenapine is somnolence. However, the somnolence associated with asenapine
use did not cause significant rates of discontinuation. While asenapine was
associated with weight gain when compared to placebo, it appeared to be modest
when compared to other atypical antipsychotics, and its propensity to cause
increases in hemoglobin A1c or serum lipid levels appeared to be similarly
modest. Asenapine does not appear to cause any clinically significant QTc
prolongation. The most commonly reported extra-pyramidal symptom associated with
asenapine was akathisia. Overall, asenapine appears to be a relatively
well-tolerated atypical antipsychotic, effective in the treatment of acute manic
and mixed episodes of BD.