Bysanti (Milsaperidone) for Schizophrenia

Bysanti (milsaperidone) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating schizophrenia in adults.

How Bysanti Works and How It’s Taken

Bysanti is a type of medication called an atypical antipsychotic that may work by affecting brain chemicals like dopamine and serotonin. The exact way Bysanti works in schizophrenia is not fully known.

Doctors prescribe Bysanti to adults with schizophrenia.

Bysanti is given as a tablet by mouth, typically twice daily, with or without food. It is started at a low dose and raised over several days before continuing on a regular twice-daily schedule.

Typical Dosing for Schizophrenia

The recommended starting dose of Bysanti for schizophrenia is:

1 milligram twice daily on day 1
2 milligrams twice daily on day 2
4 milligrams twice daily on day 3
6 milligrams twice daily on day 4
8 milligrams twice daily on day 5
10 milligrams twice daily on day 6
12 milligrams twice daily on day 7

For some people with schizophrenia, a doctor may choose to continue 6 milligrams twice daily starting on day 5 instead of increasing further. This depends on how each person responds.

For people who respond to treatment, the recommended maintenance dose is 6 milligrams to 12 milligrams twice daily.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Bysanti Side Effects

In clinical studies of adults taking Bysanti for schizophrenia, the most common side effects occurred in about 5 percent to 20 percent of people in these trials. They include:

Dizziness
Somnolence (sleepiness)
Dry mouth
Fatigue (feeling tired)
Nasal congestion (stuffy nose)
Tachycardia (fast heartbeat)
Orthostatic hypotension (drop in blood pressure when standing)
Weight gain

Serious Side Effects and Warnings

Bysanti can cause serious side effects that may require immediate medical attention. These include:

Increased risk of death in older adults with dementia-related psychosis — Bysanti is not approved for dementia-related psychosis.
Stroke and transient ischemic attack (TIA, sometimes called a ministroke) — These can occur in older adults with dementia-related psychosis.
QTc prolongation — This heart rhythm change can lead to dangerous irregular heartbeats.
Neuroleptic malignant syndrome (NMS) — This rare, life-threatening reaction can cause high fever, severe muscle stiffness, confusion, and unstable blood pressure or heart rate.
Tardive dyskinesia (TD) — Uncontrolled movements, often of the face or tongue, may not go away.
Metabolic changes — These can include high blood sugar, unhealthy cholesterol or triglyceride levels, and weight gain.
Orthostatic hypotension and syncope — Light-headedness or faintness can be caused by a sudden change in heart rate and blood pressure when rising quickly from a sitting or lying position.
Increased risk of falls — Falls could cause fractures or other injuries.
Seizures — Seizures may occur.
Decrease in infection-fighting white blood cells — This can increase the risk of infection.
Hyperprolactinemia — High prolactin levels can cause breast milk production, missed periods, breast enlargement, sexual side effects, and may affect bone density over time.
Problems with body temperature regulation — Overheating or dehydration can occur.
Dysphagia (trouble swallowing) — This can raise the risk of choking or breathing food or liquid into the lungs.
Priapism — A painful erection that lasts a long time can require urgent treatment.
Intraoperative floppy iris syndrome — This eye problem can happen during cataract surgery.

Get medical help right away if you think you are having a serious reaction.

What To Know Before Taking Bysanti

Before starting Bysanti, your doctor may check your blood sugar, blood fats, blood potassium and magnesium levels, and weight. They may also recommend a genetic test before starting Bysanti to see how your body processes the medication, as this can affect the right dose for you. Individuals who process it slowly, called poor metabolizers, may need a different dosing schedule.

Tell your doctor if you have any allergies to milsaperidone or any ingredients in Bysanti. Do not take Bysanti if you have had a serious allergic reaction to milsaperidone or any of its ingredients.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.

Tell your healthcare provider about any medical conditions that you have, including problems with your liver. Bysanti is not recommended for individuals with severe liver problems.

When taking Bysanti, you should avoid drinking alcohol.

If you miss more than three days of Bysanti, you will need to restart the dosing schedule from the beginning or as directed.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Bysanti, talk with your doctor about the risks and benefits. Do not breastfeed during Bysanti treatment and for six to eight days after the last dose, depending on how well your body processes the medication.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Bysanti?

In short-term studies of adults with schizophrenia, iloperidone, the medication used to support Bysanti’s approval, worked better than a placebo (an inactive treatment) over four to six weeks. In a longer relapse-prevention study, adults who stayed on iloperidone had a significantly longer time to relapse (symptoms coming back) than those switched to placebo.

How long does Bysanti take to work for schizophrenia?

It is not known exactly how quickly Bysanti starts to work. In studies of adults with schizophrenia, improvement was measured after four weeks in one study and six weeks in another. These studies do not show the exact day when people first begin to feel better.

What tests or monitoring are needed with Bysanti for schizophrenia?

Doctors may do some tests before and during treatment with Bysanti. Blood sugar should be checked before or soon after starting, and then checked from time to time. Blood fats, called lipids, should be checked at the start and monitored over time.

Body weight should be checked at the start and often after that. In some people, doctors may check potassium and magnesium levels to help lower the risk of heart rhythm problems. People with low white blood cell counts, or a history of this problem, should have blood tests during the first few months.

What should I do if I miss a dose of Bysanti for schizophrenia?

If you miss more than three days of Bysanti treatment, you will need to restart the dosing schedule at the starting dose.