asenapine vs paliperidone
Side-by-side comparison of asenapine and paliperidone Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Saphris
Invega
Asenapine (Saphris) is an antipsychotic medicine. It is used to treat bipolar I disorder in adults and children ages 10-17.
Paliperidone extended-release tablets, also known as Invega, are a type of antipsychotic medicine. It helps manage symptoms of certain mental disorders.
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.
This medicine is used to treat schizophrenia in adults and teens (12-17 years old). It can also treat schizoaffective disorder in adults, either alone or with other medicines like mood stabilizers or antidepressants. Schizophrenia can cause hallucinations, delusions, and confused thinking. Schizoaffective disorder includes symptoms of both schizophrenia and mood disorders.
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.
Paliperidone affects certain chemicals in the brain. These chemicals, like dopamine, can become unbalanced in people with schizophrenia and schizoaffective disorder. By acting on these chemicals, paliperidone helps to reduce symptoms.
- • Sleepiness
- • Numbness in the mouth
- • Dizziness
- • Changes in taste
- • Nausea
- • Extrapyramidal symptoms (movement problems)
- • Fast heart rate
- • Feeling restless and unable to sit still
- • Sleepiness
- • Indigestion
- The medicine is not working 110
- Interaction with another medicine 78
- Using the medicine for a condition it is not approved for 70
- Poisoning from different substances 64
- Death by suicide 61
- Physical harm or wound 4,330
- Enlargement of male breast tissue 3,664
- Medication not working 1,729
- Unusual increase in weight 1,660
- Using medication for a non-approved purpose 1,501
Asenapine may increase the risk of death in elderly patients who have psychosis related to dementia. Asenapine is not approved to treat this condition.
This medicine has a boxed warning. It may increase the risk of death in elderly patients with dementia-related psychosis. Paliperidone is not approved to treat this condition.
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.
If you are pregnant or plan to become pregnant, talk to your doctor. Babies born to mothers who use this medicine in the last 3 months of pregnancy may have withdrawal symptoms or movement problems after birth. There is a pregnancy registry to monitor outcomes in women exposed to atypical antipsychotics during pregnancy. You can contact the registry at 1-866-961-2388.
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How to Read This asenapine vs paliperidone Comparison
asenapine is classified in the Atypical Antipsychotic drug class, while paliperidone 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 383 submissions while paliperidone has 12,884. 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 substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between asenapine and paliperidone — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.