{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T03:13:38Z","timestamp":1782789218096,"version":"3.54.5"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Psychopharmacology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Gastric malabsorptive conditions may prevent patients from deriving benefit from orally administered medications intended for enteric absorption. While malabsorption is an increasingly common issue, current data on alternative oral options for agitation in these patients are very sparse. Sublingual (SL) asenapine is absorbed transmucosally, bypassing gut absorption, making it a viable consideration. We report on three patients, one with short bowel syndrome, one with viral gastritis, and one with aortic dissection who were trialed on SL asenapine for agitation after failing alternative antipsychotics. Two of these patients had an extensive history of psychiatric admissions for bipolar disorder and substance-induced psychosis. All three patients had significant reductions in agitation within 1\u20135 days, with no reported adverse effects. However, benefit of SL asenapine was hindered in two of these patients as they began inappropriately swallowing the medication, reducing bioavailability to nil. Clinicians should consider the use of SL asenapine for medically complex agitated patients where gastric absorption is questionable. There is an urgent need for guidelines on this matter, as well as more, alternative dosage forms for various medications that may help with agitation in this population.<\/jats:p>","DOI":"10.1177\/20451253241263714","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T04:16:35Z","timestamp":1721880995000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Sublingual asenapine for agitation in malabsorptive states: three patient cases"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2681-3785","authenticated-orcid":false,"given":"Bradley G.","family":"Burk","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham Medical Center, Department of Pharmacy, JT1728, 619 19th Street South, Birmingham, AL 35222, USA"},{"name":"University of Alabama at Birmingham Medical Center, Department of Psychiatry, Birmingham, AL, USA"},{"name":"University of Alabama at Birmingham Heersink School of Medicine, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Humphreys","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Medical Center, Department of Pharmacy, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Waites","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Medical Center, Department of Psychiatry, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bentley","family":"Adams","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Medical Center, Department of Psychiatry, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badari","family":"Birur","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Medical Center, Department of Psychiatry, Birmingham, AL, USA"},{"name":"University of Alabama at Birmingham Heersink School of Medicine, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela E.","family":"Parker","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Medical Center, Department of Psychiatry, Birmingham, AL, USA"},{"name":"University of Alabama at Birmingham Heersink School of Medicine, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"bibr1-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2006.02.011"},{"key":"bibr2-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1177\/08971900221100205"},{"key":"bibr3-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0000000000000918"},{"key":"bibr4-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1177\/009127009703700106"},{"key":"bibr5-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1177\/0091270005283839"},{"key":"bibr6-20451253241263714","unstructured":"FDA. Highlights of prescribing information: saphris package insert. Food and Drug Administration 2017. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/022117s020s021lbl.pdf (accessed 14 June 2023)."},{"key":"bibr7-20451253241263714","first-page":"443","volume":"18","author":"Huhn M","year":"2020","journal-title":"Focus (Am Psychiatr Publ)"},{"key":"bibr8-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(81)73532-1"},{"key":"bibr9-20451253241263714","doi-asserted-by":"publisher","DOI":"10.12788\/acp.0126"},{"key":"bibr10-20451253241263714","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S149376"},{"key":"bibr11-20451253241263714","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.21m14355"},{"key":"bibr12-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12609"},{"key":"bibr13-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3181d35d6b"},{"key":"bibr14-20451253241263714","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v68n1004"},{"key":"bibr15-20451253241263714","unstructured":"ASMBS. Estimate of bariatric surgery numbers, 2011\u20132020. American Society for Metabolic and Bariatric Surgery 2024, https:\/\/asmbs.org\/resources\/estimate-of-bariatric-surgery-numbers (accessed 20 June 2024)."},{"key":"bibr16-20451253241263714","unstructured":"CDC. Adult obesity facts. Center for Disease Control and Prevention 2024, https:\/\/www.cdc.gov\/obesity\/php\/data-research\/adult-obesity-facts.html (accessed 20 June 2024)."},{"key":"bibr17-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3182905ffb"},{"key":"bibr18-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1177\/0897190020905467"},{"key":"bibr19-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000402"},{"key":"bibr20-20451253241263714","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.19l02462"},{"key":"bibr21-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1177\/2045125314561221"},{"key":"bibr22-20451253241263714","volume":"51","author":"Hiemke C","year":"2018","journal-title":"Pharmacopsychiatry"},{"key":"bibr23-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2022.10.010"},{"key":"bibr24-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.21313"},{"key":"bibr25-20451253241263714","doi-asserted-by":"publisher","DOI":"10.1177\/20451253211035269"}],"container-title":["Therapeutic Advances in Psychopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20451253241263714","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20451253241263714","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20451253241263714","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:53:25Z","timestamp":1777593205000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20451253241263714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":25,"alternative-id":["10.1177\/20451253241263714"],"URL":"https:\/\/doi.org\/10.1177\/20451253241263714","relation":{},"ISSN":["2045-1253","2045-1261"],"issn-type":[{"value":"2045-1253","type":"print"},{"value":"2045-1261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"20451253241263714"}}