Evaluation of the clinical efficacy of asenapine in schizophrenia.
BACKGROUND
Asenapine is a new atypical antipsychotic medication with high affinity for D(2) and 5HT(2A) receptors that has been approved by the FDA in adults for the acute treatment of schizophrenia in the USA. The purpose of this review is to describe the compound and examine whether it addresses some of the unmet clinical needs in treating schizophrenia.


METHODS
The development of asenapine is described with attention to its chemistry, pharmacodynamic and pharmacokinetic profile. Preclinical and clinical trials of safety and efficacy are reviewed. The advantages and disadvantages of asenapine relative to other antipsychotic medications are discussed.


RESULTS
Asenapine will be evaluated for whether it: i) causes a reduction in symptoms of schizophrenia; ii) has a side-effect profile minimizing extrapyramidal symptoms, weight gain and cardiac effects; and iii) affects negative and/or cognitive symptoms.


CONCLUSIONS
Asenapine is a recently approved agent with an acceptable cardiometabolic profile and exhibits similar efficacy as other antipsychotic medications, primarily on positive symptoms of schizophrenia. Relatively less weight gain compared with other agents may confer a notable advantage. Sublingual administration may have positive and negative effects on patient compliance. Potential 'pro-cognitive' effects of asenapine are preliminary and require more investigation.
Minassian
Arpi
A
University of California San Diego, Department of Psychiatry, La Jolla, California 92093-0804, USA.
Young
Jared W
JW
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003986:Dibenzocycloheptenes; D018492:Dopamine Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006576:Heterocyclic Compounds, 4 or More Rings / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D012559:Schizophrenia / Q000188:drug therapy*; D012702:Serotonin Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003986:Dibenzocycloheptenes; D018492:Dopamine Antagonists; D006576:Heterocyclic Compounds, 4 or More Rings; D012702:Serotonin Antagonists; C522667:asenapine