What is Asenapine: Uses, Dosage, Side Effects and More

Asenapine is an antipsychotic medication that helps balance certain chemicals in your brain. It's specifically designed to dissolve under your tongue, which allows it to work more effectively than pills you swallow. This medication is commonly prescribed for serious mental health conditions like bipolar disorder and schizophrenia.

What is Asenapine?

Asenapine is a prescription medication that belongs to a group called atypical antipsychotics. It works by helping to restore the balance of natural substances in your brain, particularly dopamine and serotonin. These brain chemicals play important roles in mood, thinking, and behavior.

What makes asenapine unique is that it comes as a sublingual tablet, which means you place it under your tongue where it dissolves completely. This special delivery method helps your body absorb the medication more efficiently than traditional pills that you swallow.

The medication is available in different strengths and is typically prescribed as part of a comprehensive treatment plan that may include therapy and lifestyle changes.

What is Asenapine Used For?

Asenapine is primarily used to treat two main mental health conditions: bipolar disorder and schizophrenia. For bipolar disorder, it helps manage both manic episodes and mixed episodes, which are periods when you might experience symptoms of both mania and depression at the same time.

In schizophrenia treatment, asenapine helps reduce symptoms like hallucinations, delusions, and disorganized thinking. It can also help with negative symptoms such as reduced motivation or difficulty expressing emotions.

Sometimes doctors prescribe asenapine for other conditions when they believe it might be helpful, though this is less common. Your doctor will carefully evaluate your specific situation to determine if asenapine is right for you.

How Does Asenapine Work?

Asenapine works by blocking certain receptors in your brain that respond to dopamine and serotonin. Think of these receptors like locks, and the brain chemicals like keys. When there's too much activity at these locks, it can cause symptoms of mental illness.

By blocking some of these receptors, asenapine helps reduce overactivity in certain brain pathways while still allowing normal brain function to continue. This balancing act helps improve symptoms without completely shutting down these important brain systems.

Asenapine is considered a moderately strong antipsychotic medication. It's effective for managing symptoms but tends to have fewer severe side effects compared to older antipsychotic medications.

How Should I Take Asenapine?

Taking asenapine correctly is crucial for it to work properly. You need to place the tablet under your tongue and let it dissolve completely, which usually takes about 30 seconds to a few minutes. Don't chew, crush, or swallow the tablet whole.

Here's what you need to know about timing and food. You should avoid eating or drinking anything for 10 minutes after taking asenapine. This waiting period ensures your body can absorb the medication properly through the tissues under your tongue.

Most people take asenapine twice daily, typically in the morning and evening. Your doctor will start you on a lower dose and may gradually increase it based on how you respond to the medication and any side effects you experience.

How Long Should I Take Asenapine For?

The length of asenapine treatment varies significantly from person to person. Some people may need to take it for several months, while others might require long-term treatment lasting years. Your doctor will work with you to determine the right duration based on your condition and response to treatment.

For bipolar disorder, you might take asenapine during acute episodes and then continue it as maintenance therapy to prevent future episodes. With schizophrenia, treatment is often long-term to help maintain stability and prevent symptom relapse.

It's important never to stop taking asenapine suddenly, even if you're feeling better. Your doctor will help you gradually reduce the dose when it's time to discontinue the medication, which helps prevent withdrawal symptoms or symptom return.

What Are the Side Effects of Asenapine?

Like all medications, asenapine can cause side effects, though not everyone experiences them. Understanding what to expect can help you feel more prepared and know when to contact your doctor.

The most common side effects you might experience include drowsiness, dizziness, and changes in taste or numbness in your mouth. These mouth-related effects happen because the medication dissolves under your tongue and are usually mild and temporary.

Here are the more frequently reported side effects that tend to be manageable:

• Drowsiness or feeling sleepy during the day
• Dizziness, especially when standing up quickly
• Dry mouth or changes in taste
• Weight gain, which can be gradual
• Restlessness or feeling unable to sit still
• Nausea or stomach discomfort

These common side effects often improve as your body adjusts to the medication over the first few weeks of treatment.

Some people may experience more serious side effects that require immediate medical attention. While these are less common, it's important to be aware of them so you can seek help if needed.

Serious side effects that need prompt medical care include:

• Severe muscle stiffness or spasms
• High fever with confusion or sweating
• Irregular heartbeat or chest pain
• Severe dizziness or fainting
• Difficulty swallowing or breathing
• Uncontrollable movements of face, tongue, or limbs

If you experience any of these serious symptoms, contact your doctor immediately or seek emergency medical care.

There are also some rare but potentially serious long-term effects to be aware of. These include a condition called tardive dyskinesia, which involves involuntary movements that can become permanent. Your doctor will monitor you regularly to catch any early signs of this condition.

Another rare but serious concern is neuroleptic malignant syndrome, a potentially life-threatening reaction that causes high fever, muscle rigidity, and changes in mental status. While this is extremely uncommon, it's important to know the warning signs.

Who Should Not Take Asenapine?

Asenapine isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. Certain medical conditions or circumstances make asenapine potentially unsafe or less effective.

You shouldn't take asenapine if you're allergic to it or have had severe reactions to similar medications in the past. People with certain heart conditions, particularly those with irregular heartbeats or a history of heart attacks, may need special monitoring or alternative treatments.

Here are situations where asenapine requires extra caution or may not be recommended:

• Dementia-related psychosis in elderly patients
• Severe liver disease
• History of seizures or epilepsy
• Diabetes or high blood sugar
• Low white blood cell count
• Difficulty swallowing
• Pregnancy or breastfeeding

Your doctor will weigh the potential benefits against the risks in these situations and may recommend alternative treatments or require closer monitoring if asenapine is still the best option for you.

Asenapine Brand Names

Asenapine is available under the brand name Saphris in the United States. This is the most commonly prescribed form of the medication and the one your pharmacy will typically stock.

In some other countries, asenapine may be available under different brand names, but the medication itself remains the same. Always make sure you're getting the correct medication by checking with your pharmacist if you have any questions.

Generic versions of asenapine are also available, which contain the same active ingredient but may cost less than the brand-name version.

Asenapine Alternatives

If asenapine isn't right for you, there are several alternative medications your doctor might consider. Other atypical antipsychotics like olanzapine, quetiapine, or aripiprazole work similarly but have different side effect profiles.

For bipolar disorder specifically, mood stabilizers like lithium or anticonvulsants such as valproic acid might be alternatives. Your doctor might also consider combination therapies that use lower doses of multiple medications.

The choice of alternative depends on your specific symptoms, medical history, and how you've responded to other treatments in the past. What works best varies significantly from person to person.

Is Asenapine Better Than Olanzapine?

Both asenapine and olanzapine are effective antipsychotic medications, but they have different strengths and weaknesses. The "better" choice depends entirely on your individual situation and needs.

Asenapine may cause less weight gain and fewer metabolic problems compared to olanzapine, which can be important if you're concerned about diabetes or heart disease. However, olanzapine has been studied longer and may be more effective for certain symptoms.

The sublingual delivery method of asenapine can be an advantage for some people, as it may work faster and cause fewer stomach-related side effects. Your doctor will help you weigh these factors based on your specific health profile and treatment goals.