title: Asenapine prescribing patterns in the treatment of manic in- and outpatients: Results from the MANACOR study.
abstract: BACKGROUND
  Asenapine is the most recent compound that has been FDA- and EMA-approved for treatment of mania. Its efficacy and safety have been assessed in placebo-controlled trials, but little is known about its performance in routine clinical conditions. In this study, we compared features of patients treated with adjunctive asenapine or other adjunctive antipsychotics and the costs of the treatment.
  
  
  METHODS
  A combined prospective and retrospective data collection and analysis was conducted from January 2011 to December 2013 following a clinical interview and assessment of manic and depressive symptoms (YMRS, HDRS-17), clinical state (CGI-BP-M), psychosocial functioning (FAST), sexual dysfunction (PRSexDQ) and health resource costs associated with treatment with adjunctive asenapine versus other adjunctive antipsychotics.
  
  
  RESULTS
  Hundred and fifty-two patients from different university hospitals were included. Fifty-three patients received adjunctive asenapine and 99 received other adjunctive antipsychotics concomitantly to mood stabilizers. Considering inpatients, those treated with adjunctive asenapine presented a significantly less severe manic episode (P=0.001), less psychotic symptoms (P=0.030) and more comorbid personality disorder (P=0.002). Regarding outpatients, those treated with adjunctive asenapine showed significantly less severe manic episode (P=0.046), more previous mixed episodes (P=0.013) and more sexual dysfunction at baseline (P=0.036). No significant differences were found in mean total costs per day.
  
  
  CONCLUSIONS
  Clinicians tended to use adjunctive asenapine in patients with less severe manic symptoms but more complex clinical profile, including more mixed episodes in the past, concomitant personality disorder, and sexual problems. Treatment with adjunctive asenapine was not associated with higher costs when compared to other options.
authors: Bipolar Disorders Unit, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, 08036 Barcelona, Catalonia, Spain.
authors: I
authors: I
authors: Grande
authors: Bipolar Disorders Unit, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, 08036 Barcelona, Catalonia, Spain.
authors: D
authors: D
authors: Hidalgo-Mazzei
authors: Mental Health Division of Althaia, Xarxa Assistencial Universitária de Manresa, Catalonia, Spain.
authors: E
authors: E
authors: Nieto
authors: Psychiatric Service, Santa Maria Hospital, IRB Lleida (Biomedicine Research Institute), University of Lleida, Lleida, Catalonia, Spain.
authors: M
authors: M
authors: Mur
authors: University Psychiatric Hospital, Institut Pere Mata, IISPV, URV, CIBERSAM, Reus, Catalonia, Spain.
authors: C
authors: C
authors: Sàez
authors: Psychiatric Service, Santa Maria Hospital, IRB Lleida (Biomedicine Research Institute), University of Lleida, Lleida, Catalonia, Spain.
authors: I
authors: I
authors: Forcada
authors: Bipolar Disorders Unit, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, 08036 Barcelona, Catalonia, Spain. Electronic address: evieta@clinic.ub.es.
authors: E
authors: E
authors: Vieta
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy*; D003863:Depression / Q000188:drug therapy; D003986:Dibenzocycloheptenes; D005260:Female; D006576:Heterocyclic Compounds, 4 or More Rings / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000188:drug therapy; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings; C522667:asenapine
keywords: Antipsychotic; Asenapine; Bipolar disorder; Burden; Cost