Asenapine (Saphris)

Asenapine (brand name, Saphris) is the latest atypical antipsychotic medication approved by the FDA. Manufactured by Schering-Plough, the approval occurred in the latter part of 2009. Unlike all other prior antipsychotic medications, asenapine was approved simultaneously for both adult schizophrenia and manic and mixed bipolar episodes.

What it’s used to treat

Asenapine is used to treat schizophrenia in adults. It is also used to treat manic and mixed episodes in individuals with bipolar disorder.

How it works

The exact mechanism by which asenapine works is not yet fully understood. Like many antipsychotic medications, it is believed to impact both dopamine and serotonin, two chemicals (neurotransmitters) in the brain 1.

Studies have shown that asenapine may reduce the likeliness of relapse in schizophrenics 2. While initial studies suggested asenapine may be more effective in treating the negative symptoms of schizophrenia, other studies suggest it is not more effective 3.

How it’s administered

Asenapine is available as sublingual tablets. Sublingual tablets are placed under the tongue where they are quickly absorbed.

Potential side effects

As with all medications, asenapine may cause a variety of side effects. The most common ones include drowsiness, dizziness, weight gain, headache, dry mouth, aching joints, difficulties sleeping, nausea, vomiting, increase in appetite and saliva.

Other potential side effects include, but are not limited to:

Extreme allergic response, difficulties breathing, fainting, uncontrolled body movements, sweating, elevated blood sugar, changes in heartbeat, restlessness, fever and chills, difficulties swallowing, seizures, and suicidal ideation and behavior.

Asenapine also has the potential for tardive dyskinesia (TD) and neuroleptic malignant syndrome (NMS), two side effects often associated with antipsychotic medications.

TD can become a permanent condition for some individuals. TD symptoms involve involuntary, random and uncontrollable movements, such as lip smacking, odd tongue or jaw movements, blinking, grimacing, and movements involving the limbs, fingers, toes, upper body or hips.

Neuroleptic malignant syndrome is especially concerning because it can be fatal. Some of the symptoms of NMS include muscle stiffness, changes in one’s mental state, fluctuations in blood pressure or heartbeat, sudden renal failure, tremors, difficulty breathing, dehydration, rapid heartbeat, and extremely high temperature.


Before taking asenapine, it is important to let your doctor know of any current medications or allergies to any medications. You should also let your doctor know if you or a family member has any history of conditions including, but not limited to, low white blood cell counts, irregular or slow heartbeat, any imbalances in electrolytes, diabetes, seizures, epilepsy, kidney or heart disease, any type of dementia, and any heart problems. Also, if you are nursing or pregnant, or thinking about becoming pregnant, be sure to tell your doctor.

written by Dr. Cheryl Lane, PsyD


  1. "Asenapine for schizophrenia and bipolar I disorder," Current Psychiatry
  2. New "Antipsychotic Drug Asenapine (Saphris) Helps Prevent Relapse In People With Schizophrenia; Phase III Data Presented At ECNP," Medical News Today
  3. APA: New Drug No Better for Negative Schizophrenia Symptoms