The need for cost-effective choices to treat patients with bipolar 1 disorders including asenapine

Bipolar 1 disorders (BPD) are a chronic disorder with prevalence rates up to 2.6% of the adult population or higher and appreciable direct and indirect costs. As a result, a concern to health authorities especially given the low age of onset. Consequently, a need to treat BPD patients well and improve their quality of life. Pharmacotherapy includes mood stabilisers and atypical antipsychotics (AAPs). AAPs have different mechanisms of action and side-effects so treatment needs to be tailored. Asenapine in clinical trials is as effective as olanzapine with less metabolic side-effects. Chitnis and colleagues have shown in routine care that asenapine also reduces hospital and emergency room admissions making it cost neutral in BPD, which is of interest to health authorities and clinicians.