What To Know About Saphris (Asenapine)

A Sublingual Medication Used to Treat Schizophrenia and Bipolar Disorder

Pill in hand

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Saphris (Asenapine) is a medication used to treat mental health disorders such as schizophrenia and bipolar disorder.

It belongs to a class of drugs known as atypical antipsychotics which help to treat conditions like schizophrenia and bipolar 1 disorder by balancing the chemical messengers in your brain. 

The exact mechanism of atypical antipsychotics is unclear. However, Saphris is believed to help alleviate positive and negative symptoms of schizophrenia, and symptoms of bipolar 1 disorder, by blocking dopamine receptors in the brain, to control the regulation of the chemical messenger.

The hyperactivity and hypoactivity of dopamine in the brain have long been linked to psychotic disorders like schizophrenia.


Saphris is approved by the FDA for treating the following conditions: 

  • Schizophrenia: Saphris is used for both acute and maintenance treatment of schizophrenia symptoms. Research shows that it is effective in improving positive and negative symptoms of the condition.
  • Bipolar 1 disorder: Saphris is effective for treating manic episodes that occur in people who have bipolar 1 disorder. It is also used to prevent the recurrence of manic or mixed episodes.

Before Taking 

Before this medication is prescribed for you, you should disclose if you are taking any other medications, supplements, and vitamins to your doctor.

People who have a history of heart and liver diseases are typically discouraged from taking this medication. If this applies to you, it’s important you disclose this to your doctor. 

Precautions and Contraindications 

While Saphris has been approved by the FDA to treat certain mental disorders, it is not approved for treating people who have dementia-related psychosis.

Research shows that older people with dementia-related psychosis who are treated with antipsychotic drugs like Saphris have an increased risk of dying. 

If you have a medical or family history of asenapine allergy, your doctor won’t prescribe Saphris to you.

Signs of an allergic reaction to asenapine include:

  • Difficulty breathing
  • Lightheadedness
  • Itching
  • Swelling of the face
  • Tongue
  • Throat

Your doctor is also unlikely to prescribe Saphris, if you are pregnant, as it may cause breathing and feeding problems for your baby.

Other Atypical Antipsychotics

Atypical antipsychotics are also known as second generation antipsychotic drugs. They work by inhibiting dopamine receptors in the brain, which helps to treat symptoms of psychosis.

Some other common types of atypical antipsychotics include: 

  • Clozaril (clozapine): This is typically used to treat, treatment-resistant schizophrenia. 
  • Abilify (aripiprazole): This is used to treat bipolar disorder and schizophrenia. It may also be used to treat major depressive disorder (MDD).
  • Invega (paliperidone): This is used to treat schizophrenia.
  • Zyprexa (olanzapine): This is used to treat bipolar disorder and schizophrenia.


Saphris is a prescription medication and dosage is typically recommended by your doctor.

Dosage is usually based on your medical condition, personal needs, tolerability to the drug, and other medication you might be taking. 

  • Schizophrenia: 5 milligrams of Saphris administered twice daily, is the typical recommended dosage when using this medication to treat schizophrenia. If there are no uncomfortable side effects, this dosage might be increased to 10 milligrams in certain cases.
  • Bipolar I disorder: 5 to 10 milligrams given twice daily is typically prescribed for adults with this condition. 


Saphris has been approved by the FDA to treat Bipolar I disorder in children between the ages of 10 and 17.

They are typically started at a dosage of 2.5 milligrams twice daily, but this can be increased to as high as 10 milligrams daily depending on the child’s needs and response to treatment.

There isn’t enough research to support the safety of administering any doses higher than 10 mg.  

When being administered as supplement instead of the primary medication, the recommended starting dose is typically 5 milligrams. 

How to Take and Store

Saphris is a sublingual tablet, this means that it can be easily absorbed in your mouth. 

When taking this medication it’s important to put the whole pill in your mouth and let your saliva dissolve it.

Do not swallow it whole, break it up or chew it. Also, it's best to avoid eating or drinking anything for up to 10 minutes after taking this medication.

You should store the medication in a cool dry place away from children and pets. You should use dry hands when taking this medication. 

Side Effects

Most people who use Saphris do not experience any severe side effects. Before prescribing it to you, your doctor would have examined your medical and family history to determine if it’s the right medication for you.

More severe side effects typically occur as a result of contraindications with other medications or other underlying medical conditions.


Some of the most common side effects you might experience when using Saphris include: 

  • Sleepiness
  • Dizziness 
  • Muscle stiffness
  • Weight gain 
  • Nausea 
  • Restlessness
  • Numbing of the mouth 

These side effects are nothing to worry about and will usually go away a couple of hours after you’ve taken your medication. However, if they persist or become more bothersome you should speak to your doctor about it. 


People using Saphris may experience some severe side effects such as: 

  • Stroke
  • High blood sugar 
  • Seizures
  • Difficulty swallowing 

If you experience any severe side effects while using Saphris, you should speak to your doctor immediately. 

Warnings and Interactions 

If you are already on antihypertensive drugs, Saphris may enhance some of their effects. It’s important to monitor your blood pressure if you are using both medications. 

In rare cases, some people who use Saphris might be at an increased risk of developing neuroleptic malignant syndrome (NMS).

NMS is a rare but fatal reaction to antipsychotic drugs like Saphris. Symptoms of this condition include cardiac dysrhythmia, irregular blood pressure or pulse, and muscle rigidity.

If you notice any of these symptoms, you should speak to your doctor immediately. If a diagnosis of NMS is made, your doctor will immediately discontinue your use of Saphris. 

Even if you start to notice a significant improvement in your symptoms, you shouldn't stop using Saphris except if you’ve been advised to do so by your doctor.

In some people, Saphris might cause them to become dehydrated and overheated. It’s important to stay hydrated and avoid overheating.

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Article Sources
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  4. Research C for DE and. FDA Drug Safety Communication: Serious allergic reactions reported with the use of Saphris (Asenapine maleate). FDA. Published online June 28, 2019.

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