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While the FDA has approved black-cherry-flavored asenapine, several countries have prescribed only unflavored versions. Specifically, Asians commonly report experiencing the bitterness of asenapine because they are more sensitive to bitter tastes than other ethnic groups. In this study, with the aim of improving adherence by reducing the bitterness of asenapine, we investigated the effects of <jats:sc>d<\/jats:sc>-sorbitol, which reduced the bitterness parameters of taste sensors in our previous basic study on the bitterness and continuity of asenapine among patients with schizophrenia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Twenty adult patients with schizophrenia were included in this single-blind, placebo-controlled, crossover trial. Participants rinsed their mouths with single-administration of <jats:sc>d<\/jats:sc>-sorbitol or a placebo prior to each administration of asenapine. We then conducted the questionnaires and assessed changes in the bitterness of asenapine (primary end point) and willingness to continue its use (secondary end point).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p><jats:sc>d<\/jats:sc>-sorbitol significantly improved the bitterness of asenapine (<jats:italic>p<\/jats:italic>\u2009=\u20090.038). Although it did not significantly increase the willingness to continue asenapine (<jats:italic>p<\/jats:italic>\u2009=\u20090.180), it did show improvement over the placebo in enhancing willingness to continue, especially in patients who were not accustomed to its taste.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our findings indicate that single-administration of <jats:sc>d<\/jats:sc>-sorbitol significantly reduces the bitterness of asenapine. In countries where flavored asenapine is not available, this finding could benefit patients who were not accustomed to its bitter taste.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>This study was registered in the Japan Registry of Clinical Trials (jRCTs041210019) on May 14, 2021.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12888-024-05549-x","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T13:03:04Z","timestamp":1706619784000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of single-administration of d-sorbitol pretreatment on the bitterness and continued willingness to take asenapine: a randomized, single-blind, placebo-controlled, crossover trial"],"prefix":"10.1186","volume":"24","author":[{"given":"Shuhei","family":"Wada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunihiro","family":"Iwamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Okumura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotake","family":"Hida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuichi","family":"Hiraoka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Kamei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Mori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyofumi","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Ando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Ozaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"issue":"4","key":"5549_CR1","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1093\/schbul\/sbac041","volume":"48","author":"A Ceraso","year":"2022","unstructured":"Ceraso A, Lin JJ, Schneider-Thoma J, Siafis S, Heres S, Kissling W, Davis JM, Leucht S. 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This study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"SW has received speakers\u2019 honoraria from Sumitomo Pharma. KI has received speakers\u2019 honoraria from Eisai, Kyowa, Meiji Seika Pharma, MSD, Otsuka, Sumitomo Pharma, Taisho, Takeda, Towa, Viatris, and Yoshitomi, outside the submitted work. HO has no conflicts of interest to declare. HH has no conflicts of interest to declare. SH and AK are full-time employees of Meiji Seika Pharma. DM has no conflicts of interest to declare. KY has no conflicts of interest to declare. MA has received research grant from Kyowa Kirin. Co. Ltd. NO has received research support or speakers\u2019 honoraria from, or has served as a consultant to, Sumitomo Dainippon, Eisai, Otsuka, KAITEKI, Mitsubishi Tanabe, Shionogi, Eli Lilly, Mochida, DAIICHI SANKYO, Nihon Medi-Physics, Takeda, Meiji Seika Pharma, EA Pharma, Pfizer, MSD, Lundbeck Japan, Taisho Pharma, Janssen, UCB, Shionogi, Nihon Medi-Physics, Tsumura, Novartis, and Astellas. MI has received speakers\u2019 honoraria from Sumitomo Pharma, Eisai, Otsuka, Tanabe Mitsubishi, Mochida, Takeda, Meiji Seika Pharma, EA Pharma, Viatris, MSD, Janssen, Lundbeck, and Yoshitomi.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"81"}}