What is Fanapt?

Fanapt is a newly approved drug for the treatment of Schizophrenia. It is the latest arrival in a family of medications known as "Atypical antipsychotics." Fanapt is manufactured by Vanda Pharmaceuticals. In this article I would like to briefly explain the way that Fanapt (and similar medications) work, describe the recommended dosages and prescautions associated with Fanapt, and give some practical advice regarding the product. I am a registered pharmacist with over 20 years experience in the industry. As I have stated in other articles, I have no direct financial or other interests in this pharmaceutical company (or any other for that matter). My goal is simply to explain, in a manner that is easy to understand, how to safely and effectively use this medication. I hope this information is helpful as you make important decisions about your own healthcare, or the healthcare of others.

As I try to always say, nothing in this article is intended to replace the advice of your personal physician and/or pharmacist. Please do not make any changes to your medication program without first consulting your doctor. I am happy to try to answer questions, but in no way want this information to deter you from getting the advice of your own healtcare provider.

 Fanapt (iloperidone) is part of the "Atypical antipsychotic" family used to treat schizophrenia.  Let me try to explain what that means.  Historically, antipsychotics (such as haloperidol or Thorazine) were only effective at relieving some of the symptoms associated with the disease of schizophrenia.  We called those symptoms the "positive" symptoms.  They included things like halucinations and hearing voices and delusions.  Other symptoms, known as the "negative" symptoms, were more difficult to manage.  These included things such as lack of motivation and interest, lack of desire for pleasure, blunted personality, and so forth.  Then along came a drug called Clozaril back in the late 1980's.  This began a new era of marketing and development in the treatment of this disease.  Clozaril, and the drugs which followed, became known as the "Atypical Antipsychotics" because they could manage those symptoms which "typically" were not improved with previous therapies.

Other "Atypical Antipsychotics" currently on the market include drugs such as:

• Abilify
• Geodon
• Invega
• Risperdal
• Seroquel
• Zyprexa

All of these drugs work in a similar way, though the mechanism is not at all fully understood.  They seem to work by influencing the levels of certain neurotransmitters in the brain, in particular the levels of Dopamine, Seratonin, and to some degree, Norepinephrine.  The varying degree in which these drugs impact these neurotransmitters creates some variety in the individual effectiveness and side-effects of each of the respective agents.  No one of them is clearly "better" than any of the others, and the side effects associated with each one may differ from person to person.

Those wondering "what is Fanapt?" will proabably also be interested in how this drugs is currently supplied. Fanapt comes as a white, round tablet and is available in the following strengths:

• 1mg
• 2mg
• 4mg
• 6mg
• 8mg
• 10mg
• 12mg

The recommended dose of Fanapt is 12 to 24mg per day. This is usually broken up into 2 daily doses (morning and evening). Therefore, if your doctor wants you to take 16mg per day, he or she could prescribe the 8mg tablet for you to take twice daily. Typically, however, your starting dose will be much lower, and is slowly increased as your body adjusts to the medication.

Side effects from Fanapt are similar to other medications in this class and include:dizziness, dry mouth, fatigue, nasal congestion, orthostatic hypotension (dizziness when standing quickly), somnolence (drowsiness), tachycardia (irregular heart beat), and weight increase (Oh yeah!).

A more serious, and potentially fatal, side effect with Fanapt is known as QT prolongation. This is a dangerous change in the rhythm of the heart. It is rare, but because it is possible, the manufacturer recommends that other treatment options be considered prior to the use of Fanapt. These risks should be carefully considered by both patient and doctor prior to beginning treatment with Fanapt.

Patients should be reminded about the risk of severe dizziness, especially upon rising quickly, and especially at the beginning of therapy.  For this reason, your doctor will probably start you on a lower dose, and slowly increase it.  Patients should also avoid alcohol while taking Fanapt.  Unusual muscle pain or stiffness should be reported to your physician as well.

I hope this information has been helpful in answering the question "What is Fanapt?"

General information on the treatment of Schizophrenia is available from the National Institute on Mental Health by clicking HERE.