A Novel Treatment Option for Schizophrenia

Abstract

of schizophrenia, many patients do not benefit from or tolerate currently available antipsychotics. Two emerging agents recently received FDA approval: asenapine (reviewed in our last issue) and iloperidone, the focus of this article. Iloperidone (Fanapt, Vanda Pharmaceuticals, Inc.) is a novel mixed 5-HT2a/D2 antagonist, similar to other second-generation antipsychotics (SGAs). After initially being turned down by the FDAin July 2008 because of concerns about its efficacy compared with risperidone, it was approved in May 2009 for the acute treatment of schizophrenia. The recommended dose range is 12–24 mg/d titrated over the first week to minimize the risk of orthostatic hypotension. A six-marker genotype is also provided to aid in predicting clinical response. This article reviews the mechanism of action of iloperidone, data supporting its use in schizophrenia, and its safety profile.