Side Effects of asenapine: A Synthesis of Findings from 19 Studies

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Original Abstract of the Article

Major Research Findings

Asenapine is a second-generation antipsychotic that has been shown to be effective in treating schizophrenia and bipolar disorder. However, like other antipsychotics, it can cause various side effects. Research has indicated that asenapine may lead to weight gain, drowsiness, and extrapyramidal symptoms. Additionally, asenapine may cause metabolic abnormalities, therefore, patients need regular checkups. On a positive note, asenapine has shown a lower risk of causing weight gain compared to other medications. 6

Reasons for Side Effects

The side effects associated with asenapine are primarily attributed to its mechanism of action. Asenapine exerts its effects by interacting with receptors for neurotransmitters such as dopamine and serotonin. These receptors play a crucial role in regulating various bodily functions, and it is believed that the interaction of asenapine with these receptors contributes to the development of side effects. 9

Common Side Effects

Weight Gain

Asenapine may lead to weight gain, which is a common concern with atypical antipsychotics. The exact mechanism behind this is not fully understood, but it is believed to involve the drug's interaction with dopamine D2 receptors and serotonin 5-HT2C receptors. 9 、 18 、 3

Drowsiness

Drowsiness is another potential side effect of asenapine. This is thought to be caused by the drug's interaction with histamine H1 receptors. 9 、 3

Extrapyramidal Symptoms

Asenapine can induce extrapyramidal symptoms, which involve involuntary movements. The mechanism behind this is believed to be related to the drug's interaction with dopamine D2 receptors. 9

Metabolic Abnormalities

Asenapine may contribute to metabolic abnormalities. It is suspected that these abnormalities are linked to weight gain. Asenapine might increase blood sugar levels, lipid levels, and cholesterol levels. 9 、 14 、 8

Countermeasures for Side Effects

Weight Gain

To mitigate weight gain, a combination of dietary modifications and regular physical activity is recommended. Consult your doctor for personalized advice on maintaining a healthy diet and incorporating exercise into your routine. It's worth noting that asenapine has demonstrated a lower risk of weight gain compared to some other antipsychotics. 6 、 11

Drowsiness

If drowsiness is a concern, adjusting the time of day you take asenapine or incorporating short naps might help. It is also advisable to avoid driving or operating machinery when feeling drowsy. 18 、 3

Extrapyramidal Symptoms

If you experience extrapyramidal symptoms, it is essential to discuss them with your doctor. They can assess the situation and adjust your medication or treatment plan accordingly. 9

Metabolic Abnormalities

Preventing metabolic abnormalities involves regular monitoring. Adhere to your doctor's instructions regarding blood sugar, lipid, and cholesterol testing. 14 、 8

Comparison between Studies

Commonalities among Studies

A consistent finding across various studies is that asenapine can potentially cause side effects such as weight gain, drowsiness, and extrapyramidal symptoms. There is also agreement that asenapine may induce metabolic abnormalities. These side effects are considered to be a consequence of asenapine's mechanism of action. 9 、 18 、 14 、 8 、 16 、 19

Differences between Studies

The specific side effects observed and their severity can vary depending on the particular study. These differences may be influenced by factors such as the characteristics of the study participants and the methodologies employed. 9 、 18 、 14 、 8 、 16 、 19

Considerations for Applying Research to Real Life

It is crucial to understand that while asenapine can be a beneficial treatment option for schizophrenia and bipolar disorder, it is not without potential side effects. When taking asenapine, it is imperative to follow your doctor's instructions meticulously. If you experience any side effects, promptly discuss them with your healthcare provider. 9 、 18 、 14 、 8 、 16 、 19

Limitations of Current Research

The research on the side effects of asenapine is still considered to be limited. More comprehensive and in-depth research is required to gain a more complete understanding. 9 、 18 、 14 、 8 、 16 、 19

Future Research Directions

Future research efforts should focus on gaining a more thorough understanding of the precise mechanisms by which asenapine induces side effects. Additionally, research should prioritize the development of strategies to mitigate these side effects. 9 、 18 、 14 、 8 、 16 、 19

Conclusion

Asenapine is a valuable tool in treating schizophrenia and bipolar disorder, but it's important to be aware of the potential for side effects. Open communication with your doctor is essential. Be sure to follow their instructions regarding medication and report any side effects promptly. By working together, you can maximize the benefits of asenapine while minimizing any potential risks. 9 、 18 、 14 、 8 、 16 、 19

Literature analysis of 19 papers
Positive Content
18
Neutral Content
1
Negative Content
0
Article Type
2
1
2
11
17
1.

Separate and combined impact of acute naltrexone and alprazolam on subjective and physiological effects of oral d-amphetamine in stimulant users.

Author: MarksKatherine R, LileJoshua A, StoopsWilliam W, RushCraig R

Stimulant abuse attenuation
Side effects

Opioid antagonists (e.g., naltrexone) and GABAA receptor modulators (e.g., alprazolam) can reduce stimulant abuse, but high doses lead to side effects. This article suggests combining naltrexone and alprazolam to maximize efficacy while avoiding side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

2.

Asenapine in the treatment of older adults with bipolar disorder.

Author: SajatovicMartha, DinesPhilipp, Fuentes-CasianoEdna, AtheyMelanie, CassidyKristin A, SamsJohnny, CleggKathleen, LocalaJoseph, StagnoSusan, TatsuokaCurtis

This 12-week trial investigates the efficacy and tolerability of adjunct asenapine in non-demented older adults with sub-optimal response to bipolar disorder (BD) treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

A review of the pharmacology, efficacy and tolerability of recently approved and upcoming oral antipsychotics: an evidence-based medicine approach.

Author: CitromeLeslie

Antipsychotic treatment
Akathisia
Extrapyramidal side effects
Metabolic abnormalities
QTc prolongation
Somnolence
Weight gain

Newly approved oral antipsychotics, including iloperidone, asenapine, and lurasidone, offer potential benefits over existing agents but differ in their side effect profiles. Lurasidone appears to minimize weight gain and metabolic abnormalities, while other agents have varying effects on QT interval, akathisia, and sedation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Combination therapy for manic phases: a critical review of a common practice.

Author: GeoffroyPierre Alexis, EtainBruno, HenryChantal, BellivierFrank

Improved manic phase control
Relapse prevention
Akathisia
Sedation
Side effects
Weight gain

Combination therapy, including an atypical antipsychotic with lithium or valproate, is superior to monotherapy in treating manic episodes of bipolar disorder in terms of efficacy and prevention of relapse. Although combination therapy is associated with more side effects, its safety profile is considered acceptable.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Clinical pharmacology of atypical antipsychotics: an update.

Author: MauriM C, PalettaS, MaffiniM, ColasantiA, DragognaF, Di PaceC, AltamuraA C

Antipsychotic treatment
Weight management

This review summarizes the clinical pharmacology and pharmacodynamic data related to atypical antipsychotics, including clozapine, risperidone, paliperidone, olanzapine, quetiapine, amisulpride, ziprasidone, aripiprazole, asenapine, iloperidone, lurasidone and cariprazine. It also provides a summary of their acute pharmacokinetic properties. Four new second-generation antipsychotics are available: iloperidone, asenapine, lurasidone and in the next future cariprazine. These new agents are advisable for the lower propensity to give weight gain and metabolic abnormalities compared with older second-generation antipsychotics. Lurasidone seems to be best in terms of minimizing unwanted alterations in body weight and metabolic variables. Therapeutic drug monitoring is not strictly necessary for all of the new antipsychotic drugs because there are no unequivocal data supporting a relationship between plasma drug levels and clinical outcomes or side effects. The exception can be represented by clozapine for which plasma levels of 350-420 ng/ml are reported to be associated with an increased probability of a good clinical response. Also for olanzapine an established therapeutic range (20-50 ng/ml) is proposed to yield an optimal response and minimize side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Acceptability of Acute and Maintenance Pharmacotherapy of Bipolar Disorder: A Systematic Review of Randomized, Double-Blind, Placebo-Controlled Clinical Trials.

Author: BaiYuanhan, YangHaichen, ChenGuanjie, GaoKeming

Tolerability
Somnolence
Weight gain

All medications studied in bipolar disorder were relatively well tolerated during different phases of treatment; however, the risk for short- and long-term weight gain and somnolence varied widely among included psychotropics.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Clinical Pharmacokinetics of Atypical Antipsychotics: An Update.

Author: MauriMassimo Carlo, PalettaSilvia, Di PaceChiara, ReggioriAlessandra, CirnigliaroGiovanna, ValliIsabel, AltamuraAlfredo Carlo

Improved efficacy
Side effects

Therapeutic drug monitoring (TDM) is being explored for second-generation antipsychotics to improve efficacy and manage side effects. The review examines the clinical pharmacokinetic data for various antipsychotics, proposing optimal plasma concentration ranges for some drugs and highlighting the need for further research on others.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Asenapine Transdermal Patch for the Management of Schizophrenia.

Author: ZhouMaxine, DerakhshanianSahar, RathAlexander, BertrandSarah, DeGrawCaroline, BarlowRachel, MenardAja, KayeAdam M, HasoonJamal, CornettElyse M, KayeAlan D, ViswanathOmar, UritsIvan

Schizophrenia treatment

Asenapine is a drug used to treat schizophrenia. This review of the literature summarizes the existing evidence for the use of asenapine in the treatment of schizophrenia, both in its sublingual and transdermal formulations.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Reversal of olanzapine-induced weight gain in a patient with schizophrenia by switching to asenapine: a case report.

Author: OkazakiKosuke, YamamuroKazuhiko, KishimotoToshifumi

Weight Loss

This study treated a case of olanzapine-induced weight gain in a patient with schizophrenia by switching his medication from olanzapine to asenapine. The weight gain improved after switching the medication, with no significant worsening of psychological symptoms or other adverse effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

12.

Unmet treatment needs in schizophrenia patients: is asenapine a potential therapeutic option?

Author: PompiliMaurizio, SerafiniGianluca, InnamoratiMarco, AmbrosiElisa, TelesforoLudovica, VenturiniPaola, GiordanoGloria, BattuelloMichele, LesterDavid, GirardiPaolo

Fewer side effects
Improved adherence
Diabetes
Dyslipidemia
Hyperglycemia
Increased adiposity

Adverse metabolic events associated with atypical antipsychotic medications are discussed. The complexity of some reports and marketing efforts may make it difficult for psychiatrists to stay informed about these complications. The review highlights the importance of medication adherence in schizophrenia and discusses the characteristics of asenapine, a new drug with a receptor profile that may be associated with fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Pharmacological approaches to the management of schizophrenia: 10 years on.

Author: CastleDavid, KeksNicholas, NewtonRichard, SchweitzerIsaac, CopolovDavid, PaolettiNick, BurrowsGraham, TillerJohn

Schizophrenia treatment
Hyperprolactinemia
Metabolic side effects

Newer antipsychotics have been developed to treat schizophrenia, but they have not led to significant improvements in overall treatment efficacy. While some newer agents might be better than older ones for negative and cognitive symptoms, they still have metabolic side effects and hyperprolactinaemia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review.

Author: SolmiMarco, MurruAndrea, PacchiarottiIsabella, UndurragaJuan, VeroneseNicola, FornaroMichele, StubbsBrendon, MonacoFrancesco, VietaEduard, SeemanMary V, CorrellChristoph U, CarvalhoAndré F

SMI treatment
Metabolic abnormalities
Weight gain

This clinical review compared the safety and tolerability profiles of selected first-generation (FGAs) and second-generation (SGAs) antipsychotics. SGAs were found to have an improved safety profile with a lower incidence of extrapyramidal side effects and less impairment of cognitive function. However, SGAs are associated with weight gain and metabolic abnormalities.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Sensory evaluation of the bitterness of asenapine using D-sorbitol pretreatment: single-blind, placebo-controlled, crossover trial.

Author: WadaShuhei, IwamotoKunihiro, OkumuraHiroki, HidaHirotake, HiraokaShuichi, KameiAya, MoriDaisuke, YamadaKiyofumi, OzakiNorio

Schizophrenia treatment
Side effects

This study aims to evaluate changes in the bitterness of asenapine among patients with schizophrenia using a D-sorbitol solution.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

The impact on functioning of second-generation antipsychotic medication side effects for patients with schizophrenia: a worldwide, cross-sectional, web-based survey.

Author: TandonRajiv, LenderkingWilliam R, WeissCatherine, ShalhoubHuda, BarbosaCarla Dias, ChenJun, GreeneMallik, MeehanStine R, DuvoldLaëtitia Bouérat, ArangoCelso, AgidOfer, CastleDavid

Antipsychotic side effects

This study aims to understand how side effects of second-generation antipsychotics impact the functioning and quality of life (QoL) of patients with schizophrenia. While antipsychotics are effective for treating schizophrenia, they can have significant side effects that may impact a patient’s daily life and overall well-being.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Asenapine: a new focus on the treatment of mania.

Author: CruzNúria, VietaEduard

Mania treatment
Schizophrenia treatment

Asenapine is a second-generation antipsychotic with high affinity for multiple receptors. It is effective and safe for the treatment of acute mania.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Up-to-date expert opinion on the safety of recently developed antipsychotics.

Author: OrsoliniLaura, De BerardisDomenico, VolpeUmberto

Good safety profile
Improved cognitive domains
Lower metabolic liability
Targeted negative symptomatology

This review provides an overview of the safety profile of recently developed or marketed antipsychotic medications, including third-generation antipsychotics (TGA). The review highlights the improved safety profile of newer antipsychotics compared to second-generation antipsychotics, particularly in terms of metabolic liability. The review also discusses the specific targeting of negative symptomatology and cognitive domains by TGA.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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