Invega vs. Saphris for Schizophrenia: Important Differences and Potential Risks.

Key takeaways

Invega (paliperidone) and Saphris (asenapine) are both atypical antipsychotics, but they have some key differences. Invega (paliperidone) is available in both brand and generic forms and is taken as an extended-release tablet once a day, while Saphris is a dissolvable tablet taken under the tongue twice a day and does not have a generic form. Invega is used to treat schizophrenia and schizoaffective disorder, whereas Saphris is used for schizophrenia and bipolar I disorder. Invega can be used in adolescents for schizophrenia, while Saphris can be used in children aged 10 and older for bipolar disorder. Common side effects of Invega include drowsiness and uncontrolled muscle movements, while Saphris often causes trouble sleeping and mouth numbness. Additionally, Saphris cannot be used in people with severe liver problems, unlike Invega.

Invega

(paliperidone)

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Asenapine

(Saphris)

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Summary for Invega

Prescription only

Invega (paliperidone) is taken by mouth and used to improve mood, thoughts, and behaviors in people who have schizophrenia or schizoaffective disorder. It's available as both brand and generic versions in an extended-release pill, which means the medication is released slowly in your body. It only needs to be taken once a day. Some common side effects include drowsiness and uncontrolled muscle movements. There are long-acting injection forms of this medication available given by a trained healthcare provider.

Indications for Invega

Schizophrenia
Schizoaffective disorder

Pros and Cons for Invega

Pros

Available in many different strengths to make it easier to customize your dose
Can be used in adolescents
Only need to take the medication once a day

Cons

You might have to see your provider several times until you find a dose that works best for you
Can make you feel sleepy or sedated
Can cause weight gain

Common Side Effects for Invega

Abnormal muscle movements (up to 40%)
Drowsiness (up to 26%)
Headache (up to 14%)
Irregular heart beat (up to 14%)
Vomiting (up to 11%)
Anxiety (up to 9%)

Warnings for Invega

Higher risk of death in older adults with dementia-related psychosis
Neuroleptic malignant syndrome (NMS)
High blood sugar, high cholesterol, and weight gain
Difficulty controlling muscle movements (tardive dyskinesia)
Higher risk of falls
High prolactin levels
Higher risk of infections
Not for people with gut problems
Heart rhythm problem (QT prolongation)

Summary for Saphris

Prescription only

Asenapine (Saphris) is an atypical antipsychotic. It's used to treat schizophrenia in adults and bipolar I disorder in people ages 10 years and older. It comes as sublingual (under the tongue) tablets in both a brand-name and generic versions. The usual dosage is to dissolve a tablet under the tongue twice a day. Some potential side effects of this medication include sleepiness, trouble sleeping, and movement problems.

Indications for Saphris

Schizophrenia in adults
Bipolar I disorder in adults and children ages 10 years and older

Pros and Cons for Saphris

Pros

Dissolved under the tongue; good option for people who have a hard time swallowing tablets
Possible option for children who have bipolar I disorder
Less likely to cause weight gain than some other antipsychotic medications, like olanzapine (Zyprexa)

Cons

Can cause drowsiness or trouble sleeping
Taken twice a day
Can't be taken by people who have severe liver problems

Common Side Effects for Saphris

Trouble sleeping (up to 16%)
Sleepiness (up to 15%)
Movement problems (up to 12%)
Restlessness (not being able to sit still, up to 11%)
Dizziness (up to 7%)
Constipation (up to 7%)
Vomiting (up to 7%)
Mouth numbness (up to 7%)

*Note: Side effects listed above were reported by adults with schizophrenia. Similar side effects are seen in adults and children with bipolar disorder.