asenapine vs risperidone
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 risperidone. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Saphris
Risperdal
Asenapine (Saphris) is an antipsychotic medicine. It is used to treat bipolar I disorder in adults and children ages 10-17.
Risperidone is a medicine used to treat certain mental disorders. It can help reduce symptoms like hallucinations, delusions, and aggression.
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.
Risperidone is used to treat schizophrenia in adults and teens. It also treats manic or mixed episodes of bipolar I disorder, either alone or with lithium or valproate. Additionally, it can help with irritability, including aggression and self-injury, in children and teens with autism.
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.
Risperidone works by changing the levels of certain natural substances in the brain. These substances are called neurotransmitters. By balancing these chemicals, risperidone can reduce symptoms of mental disorders.
- • Sleepiness
- • Numbness in the mouth
- • Dizziness
- • Changes in taste
- • Nausea
- • Parkinsonism (slowed movement, stiffness)
- • Restlessness
- • Muscle stiffness or spasms
- • Tremors
- • Sleepiness
- Drug Interaction 78
- Toxicity To Various Agents 64
- Completed Suicide 61
- Myocarditis 53
- Sedation 39
- Gynaecomastia 24,608
- Abnormal Weight Gain 9,446
- Weight Increased 9,088
- Emotional Disorder 5,947
- Injury 4,623
Asenapine may increase the risk of death in elderly patients who have psychosis related to dementia. Asenapine is not approved to treat this condition.
Risperidone may increase the risk of death in elderly patients who have dementia-related psychosis. Risperidone is not approved for treating dementia-related psychosis.
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 risperidone 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 risperidone during pregnancy. You can contact the registry at 1-866-961-2388.
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How to Read This asenapine vs risperidone Comparison
asenapine is classified in the Atypical Antipsychotic drug class, while risperidone 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 risperidone has 53,712. 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 risperidone.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.