Asenapine may benefit patients with depressive states in bipolar disorder

TORONTO — Results of a retrospective study demonstrate asenapine, an atypical antipsychotic indicated for treatment of acute manic and mixed episodes in bipolar disorder, may also have a role in treating patients with depressive states.

Diego Hidalgo-Mazzei, MD, of the Bipolar Disorders Unit, Neurosciences Institute, Hospital Clínic de Barcelona, IDIBAPS, CIBERSAM, and the University of Barcelona in Catalonia, Spain, and colleagues examined the effectiveness and tolerability of asenapine (Saphris, Forest Labs) to treat bipolar disorder in a real-world clinical setting during 1 year. Using clinical records for 94 patients treated with asenapine at four Spanish centers, Hidalgo-Mazzei and colleagues used the Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS-17) to examine mood symptoms at the initial evaluation and after 1 year alongside sociodemographics and tolerability records.

The mean age of patients was 45 years, 62.8% were female and 82% met diagnostic criteria for bipolar I, II or not otherwise specified per DSM-4-TR criteria, the researchers wrote.

More than half of patients in the bipolar subgroup (53%) had a manic episode; 6% had a hypomanic episode, approximately one-third an acute depressive episode and 13% had mixed symptoms at first evaluation, according to the poster.

Among patients with manic and hypomanic episodes, YMRS mean score reduction after 1 year was 15.7 (P < .001) and 4.2, respectively. The mean reduction in HDRS was 8.5 (P ≤ .001) in those with depressive episodes. Among patients with mixed symptoms, mean reduction in HDRS was 10.8 (P ≤ .001) and in YMRS was 13.6 (P ≤ .001).

Common adverse effects included somnolence (29.8%), dysgeusia (28.7%), oral hypoaesthesia (17%), dizziness (16%) and anxiety (12.8%).

“Asenapine proved to have good efficacy and tolerability when prescribed in real world clinical settings for manic and mixed episodes,” Hidalgo-Mazzei told Healio.com/Psychiatry. “However, it might also have a role in the treatment of depressive episodes, which have yet to be confirmed.” – by Stacey L. Adams

Disclosure: Hidalgo-Mazzei received travel grants from Lundbeck. The study was supported by the Fundació Clínic per la Recerca Biomédica.

Reference:

Hidalgo-Mazzei D, et al. #P3-025. Presented at: American Psychiatric Association Annual Meeting; May 16-20, 2015; Toronto.