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Current Trends on Antipsychotics: Focus on Asenapine.
Donatella Marazziti1, Armando Piccinni, Stefano Baroni
1Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry University of Pisa via Roma, 67 I-56100 Pisa, Italy. dmarazzi@psico.med.unipi.it.
Current Medicinal Chemistry
|May 26, 2016
Summary
Second-generation antipsychotics (SGAs) like asenapine are effective for psychotic disorders but carry metabolic risks. Asenapine shows promise for manic and mixed episodes with fewer depressive symptoms compared to other SGAs.
Area of Science:
- Psychiatry and Pharmacology
- Neuroscience
- Clinical Therapeutics
Background:
- First- and second-generation antipsychotics (FGAs, SGAs) are first-line treatments for schizophrenia and bipolar disorder.
- While effective, antipsychotics carry risks of side effects, including significant metabolic issues like weight gain and diabetes.
- Asenapine is a newer SGA approved for manic episodes and schizophrenia, known for its complex receptor binding profile.
Purpose of the Study:
- To review the pharmacological properties and clinical applications of asenapine.
- To explore potential future indications for asenapine.
- To highlight asenapine's efficacy and side effect profile in managing psychotic disorders.
Main Methods:
- Review of current data on asenapine's pharmacology.
- Analysis of clinical trial data regarding efficacy and side effects.
- Comparison of asenapine's properties with other second-generation antipsychotics.
Main Results:
- Asenapine exhibits high affinity for serotonin 5HT2A and moderate affinity for dopamine D2 receptors.
- It acts as an antagonist at 5HT2C, H1, and α2-receptors.
- Asenapine demonstrated efficacy in monotherapy or combination for manic/mixed episodes, with a lower incidence of depressive symptoms compared to other SGAs.
Conclusions:
- Asenapine is an effective SGA for schizophrenia and manic episodes.
- Its unique receptor binding profile may contribute to its efficacy in mixed states.
- Clinicians must carefully manage potential metabolic side effects associated with asenapine use.
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