asenapine vs brexpiprazole
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of asenapine and brexpiprazole. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Saphris
Rexulti
Asenapine (Saphris) is an antipsychotic medicine. It is used to treat bipolar I disorder in adults and children ages 10-17.
Rexulti is a medication used to treat certain mental health conditions. It can help with depression, schizophrenia, and agitation related to Alzheimer's disease.
Asenapine is used to treat bipolar I disorder. In children ages 10 to 17, it can treat manic or mixed episodes on its own. In adults, it can be used with lithium or valproate to treat these episodes.
Rexulti can be used with antidepressants to treat major depressive disorder in adults. It can also treat schizophrenia in adults and children 13 years and older. Additionally, Rexulti can help manage agitation in people with dementia due to Alzheimer's disease. Rexulti should not be used as needed for agitation related to dementia.
Asenapine affects certain chemicals in the brain. These chemicals are called neurotransmitters. By changing the balance of these chemicals, asenapine can help reduce symptoms of bipolar disorder.
Rexulti affects the balance of certain natural chemicals in the brain. These chemicals, called neurotransmitters, include dopamine and serotonin. By affecting these chemicals, Rexulti can help improve mood, thinking, and behavior.
- • Sleepiness
- • Numbness in the mouth
- • Dizziness
- • Changes in taste
- • Nausea
- • Weight gain
- • Feeling sleepy
- • Restlessness or feeling like you need to move
- Drug Interaction 78
- Toxicity To Various Agents 64
- Completed Suicide 61
- Myocarditis 53
- Sedation 39
- Weight Increased 1,673
- Akathisia 854
- Tremor 630
- Anxiety 591
- Tardive Dyskinesia 590
Asenapine may increase the risk of death in elderly patients who have psychosis related to dementia. Asenapine is not approved to treat this condition.
Elderly patients with dementia-related psychosis who are treated with antipsychotic drugs have an increased risk of death. Rexulti is not approved to treat dementia-related psychosis unless it is related to agitation from Alzheimer's disease. Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults and children. Tell your doctor right away if you have thoughts of harming yourself.
Tell your doctor if you are pregnant or plan to become pregnant. Babies born to mothers who use antipsychotics in the last 3 months of pregnancy may have withdrawal symptoms after birth. There is a pregnancy registry, call 1-866-961-2388.
Tell your doctor if you are pregnant or plan to become pregnant. Babies born to mothers who take Rexulti in the last 3 months of pregnancy may have withdrawal symptoms or other problems after birth. There is a pregnancy registry to monitor outcomes in women exposed to Rexulti during pregnancy. You can contact the registry at 1-866-961-2388.
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How to Read This asenapine vs brexpiprazole Comparison
asenapine is classified in the Atypical Antipsychotic drug class, while brexpiprazole sits within the Atypical Antipsychotic class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, asenapine has 295 submissions while brexpiprazole has 4,338. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for asenapine or brexpiprazole.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.