Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Asenapine(click to collapse)
1/4 selected
Asenapine
Saphris · Secuado
Second-Generation Antipsychotic
FDA-approved indications
- Schizophrenia
- Acute treatment of manic or mixed episodes associated with bipolar I disorder
- Schizophrenia (transdermal)
Off-label uses
- Bipolar depression (adjunctive)
- Agitation in dementia (limited data)
MechanismAtypical antipsychotic with broad receptor antagonism — sublingual or transdermal delivery bypasses first-pass metabolism
Half-life~24 hours
Decision GuideWhen to pick each / when to consider an alternative
Asenapine
Consider when
- Adherence concerns, swallowing difficulty, or hospitalized patients — only SGA with transdermal patch (Secuado), once-daily, bypasses sublingual food/water restrictions
- Bipolar I mania (acute or maintenance) — FDA-approved for both; bipolar maintenance indication shared by only a few SGAs (olanzapine, quetiapine, aripiprazole)
- Pediatric bipolar I mania (ages 10–17) — one of few SGAs with this specific FDA approval
- Anticholinergic sensitivity (cognitive effects, dry mouth, constipation) — no muscarinic activity, unlike olanzapine, clozapine, quetiapine
- +1 more
Consider an alternative when
- Cannot comply with sublingual administration — no eating/drinking 10 min, must dissolve under tongue, oral hypoesthesia 5–24%
- Severe hepatic impairment (Child-Pugh C) — contraindicated for sublingual formulation
- History of angioedema or anaphylaxis — reported within the first hour of first sublingual dose, a unique safety signal among SGAs
- Need for lowest-metabolic-risk SGA — aripiprazole, ziprasidone, lurasidone, cariprazine may be preferable
- +1 more
| Axis | Asenapine SGA |
|---|---|
| CNS | |
Sedation / somnolence | |
Akathisia / EPS | |
| Metabolic | |
Weight gain | |
Metabolic (glucose / lipids) | |
| Endocrine | |
Prolactin elevation | |
| Autonomic | |
Orthostatic hypotension | |
| Cardiac | |
QTc prolongation | |
| Local | |
Application/injection-site reactions | |
| Drug-specific / distinctive axes | |
Oral hypoesthesia only in Asenapine | |