Sorry for the confusion. I didn't mean does it have any recreational value; simply, does it keep the voices, delusions, obsessions etc. at bay better than what are currently the popular options (aripiprazole, quetiapine, omeprazole olanzapine)? Does it keep functional schizophrenics and bipolars out of crisis units? Does it keep the sky, clouds, mountains and plains exactly where they need to be so that you can work, rest and breed without having everything spin out of control?
The attractive thing about this drug, from what I gather from the literature, is that it doesn't cause appreciable weight gain, unlike its competitors. Even aripiprazole at, say, 30 mg qam, will result in weight gain so this appears to be the niche asenapine is trying to carve into. The problem is that it presents a higher risk of EPS than aripiprazole and maybe even than olanzapine. Particularly of concern is akathesia.
If nobody that tunes in here has actually tried it, I'll post a follow up in a few weeks.
Late entry: Also, I've heard various explanations as to why atypicals lead to metabolic abnormalities; d2 antagonism has been implicated, as well as histamine affinity and augmentation of AMP-activated protein kinase activity. The last of these sounds more sensible to me but I'm still a little confused as to how much we know about the cause of metabolic changes during antipsychotic use. Has anyone looked into this and reasoned out a mechanism? Weight gain is one of the top 4 or 5 reasons people discontinue antipsychotics and sometimes drop out of treatment altogether. For females it's often the top reason.
