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

Abstract

Adverse metabolic events, such as increased adiposity, hyperglycemia, diabetes mellitus and dyslipidemia, have been associated with treatment using atypical antipsychotic medications. However, the complexity of some of the reports on this problem and marketing efforts in this area may make it difficult for psychiatrists to remain fully and accurately informed about the metabolic complications of atypical antipsychotic therapy. Little is currently known about how psychiatrists view what they have read or heard, how they perceive the available information and how this affects their management of patients with schizophrenia. A number of studies have demonstrated that nonadherence to the medication regimen in schizophrenia is associated with poor symptomatic outcome, increased risk of relapse, more frequent use of compulsory treatment and increased risk of suicide and severe self-harm. Suicide is a major cause of death among schizophrenic patients, and their attitude toward medication can make the difference between a proper therapeutic regimen that protects patients from suicide risk versus discontinuation of treatments that are associated with disabling symptoms, some of which are risk factors for suicide. We review the characteristics of a new drug, asenapine, that may improve adherence in patients as a result of a distinctive receptor profile that may be associated with fewer side effects than other second-generation antipsychotic drugs.

Long‐term safety and efficacy of sublingual asenapine for the treatment of schizophrenia: A phase III extension study with follow‐up for 52 weeks (P06125)—Secondary publication

“…However, the mortality rate from cardiovascular disease in schizophrenia patients is reportedly 2.5-fold higher than that in the general population, 23 implying that treatment-induced metabolic abnormalities may induce cardiovascular diseases. 4 In the present study, Kaplan-Meier analysis showed that the sustained efficacy rate in subjects who responded to treatment in the preceding short-term study (PANSS responders) reached approximately 50% at 6 months and did not change significantly thereafter until 12 months, regardless of whether they were in the placebo or asenapine group in the feeder study. The results of the feeder study showed that asenapine treatment resulted in a significant improvement in the PANSS total score compared with placebo.…”

“…Thus, these medications may have a favorable impact on improving patient quality of life (QOL) and social reintegration. 2,4 However, second-generation antipsychotics have been associated with side effects such as weight gain and hyperprolactinemia. [5][6][7]…”

Treatment of metabolic syndrome and quality of life in patients with schizophrenia: a systematic review

“…People with schizophrenia are thought to be less likely to seek and use medical care, they engage in risk-taking behaviour often fail to comply with their treatment regimes (Saha et al, 2007). It is now recognized worldwide that identifying and dealing with physical illness would benefit individual patients, improving their quality of life, extending their life expectancy, and leading to improvements in their economic and social welfare (Pompili et al, 2011).…”

Efficacy and safety of asenapine in Asian patients with an acute exacerbation of schizophrenia: a multicentre, randomized, double-blind, 6-week, placebo-controlled study

“…Historically, pharmacological treatments have focused on dopamine D 2 receptor blockade to control the positive symptoms of schizophrenia, while negative and cognitive symptoms often persist (Abi-Dargham 2014 ; van Os and Kapur 2009 ). Second generation anti-psychotics, which also inhibit a range of other receptors, have been developed, but they vary in their effectiveness across mood domains (Lublin et al 2005 ; Pompili et al 2011 ). In addition, second generation anti-psychotics have differing levels of risk for weight gain and hyperprolactinemia (De Hert et al 2012 ; Kane 2011 ; Tandon et al 2010 ), which can negatively affect treatment adherence (Kane 2011 ; Lieberman et al 2005 ).…”