Trade name Bysanti
Oral Atypical antipsychotic
Approved for the treatment of schizophrenia and bipolar disorder and for treatment of major depressive disorder.
A prodrug of iloperidone (Fanapt) and acts as a dopamine D2 receptor and serotonin 5-HT2A receptor antagonist, among other actions.
Schizophrenia: Indicated as a first-line treatment for adults.
Bipolar I Disorder: Approved for the acute treatment of manic or mixed episodes in adults.
Major Depressive Disorder as an adjunctive treatment for patients with inadequate response to current antidepressants.
Milsaperidone is the major active metabolite of iloperidone (Fanapt).
Once taken orally, it rapidly interconverts to iloperidone.
It acts as an antagonist at dopamine D2, serotonin 5-HT2A, and alpha-1 adrenergic receptors.
Like other antipsychotics, it carries a warning for increased risk of death in elderly patients with dementia-related psychosis.
Common Side Effects: Dizziness, dry mouth, somnolence, nasal congestion, and orthostatic hypotension.
Precautions: Potential for QTc prolongation, weight gain, and metabolic changes.